Hospitalization in older adults: association with multimorbidity, primary health care and private health plan

Bruno Pereira Nunes, Mariangela Uhlmann Soares, Louriele Soares Wachs, Pâmela Moraes Volz, Mirelle de Oliveira Saes, Suele Manjourany Silva Duro, Elaine Thumé, Luiz Augusto Facchini

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization.METHODS: A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older) living in the urban area of the city of Bagé, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (≥ 2 and ≥ 3). The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables.RESULTS: The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8–19.6) and 10.6% (95%CI 9.1–12.1), respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition’ form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09–2.69) times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan.CONCLUSIONS: The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases.

Original languageEnglish (US)
Article number43
JournalRevista de saude publica
Volume51
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Aged
  • Comorbidity
  • Family health strategy
  • Hospitalization
  • Prepaid health care plans

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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