TY - JOUR
T1 - Hospitalization in older adults
T2 - association with multimorbidity, primary health care and private health plan
AU - Nunes, Bruno Pereira
AU - Soares, Mariangela Uhlmann
AU - Wachs, Louriele Soares
AU - Volz, Pâmela Moraes
AU - de Oliveira Saes, Mirelle
AU - Duro, Suele Manjourany Silva
AU - Thumé, Elaine
AU - Facchini, Luiz Augusto
N1 - Publisher Copyright:
© This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided that the original author and source are credited.
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Aged
KW - Comorbidity
KW - Family health strategy
KW - Hospitalization
KW - Prepaid health care plans
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U2 - 10.1590/S1518-8787.2017051006646
DO - 10.1590/S1518-8787.2017051006646
M3 - Article
C2 - 28492761
AN - SCOPUS:85021859175
SN - 0034-8910
VL - 51
JO - Revista de saude publica
JF - Revista de saude publica
M1 - 43
ER -