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Effects of Mobility and Multimorbidity on Inpatient and Postacute Health Care Utilization
- Source :
- The Journals of Gerontology: Series A. 73:1343-1349
- Publication Year :
- 2017
- Publisher :
- Oxford University Press (OUP), 2017.
-
Abstract
- Background This study examines effects of mobility and multimorbidity on hospitalization and inpatient and postacute care (PAC) facility days among older men. Methods Prospective study of 1,701 men (mean age 79.3 years) participating in Osteoporotic Fractures in Men (MrOS) Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high. Hospitalizations and PAC facility stays ascertained during 12 months following Y7. Results Reduced mobility and greater multimorbidity burden were independently associated with a higher risk of inpatient and PAC facility utilization, after accounting for each other and traditional indicators. Adjusted mean total facility days per year were 1.13 (95% confidence interval [CI] = 0.74-1.40) among men with good mobility increasing to 2.43 (95% CI = 1.17-3.84) among men with poor mobility, and 0.67 (95% CI = 0.38-0.91) among men without multimorbidity increasing to 2.70 (95% CI = 1.58-3.77) among men with high multimorbidity. Men with poor mobility and high multimorbidity had a ninefold increase in mean total facility days per year (5.50, 95% CI = 2.78-10.87) compared with men with good mobility without multimorbidity (0.59, 95% CI = 0.37-0.95). Conclusions Among older men, mobility limitations and multimorbidity were independent predictors of higher inpatient and PAC utilization after considering each other and conventional predictors. Marked combined effects of reduced mobility and multimorbidity burden may be important to consider in clinical decision-making and planning health care delivery strategies for the growing aged population.
- Subjects :
- Male
Aging
medicine.medical_specialty
Medicare
01 natural sciences
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Risk Factors
Health care
medicine
Humans
Multimorbidity
Prospective Studies
030212 general & internal medicine
Mobility Limitation
0101 mathematics
Prospective cohort study
Aged
Aged, 80 and over
Inpatients
business.industry
010102 general mathematics
Length of Stay
Patient Acceptance of Health Care
United States
Confidence interval
Gait speed
Hospitalization
Preferred walking speed
The Journal of Gerontology: Medical Sciences
Emergency medicine
Independent Living
Geriatrics and Gerontology
business
Algorithms
Subacute Care
Cohort study
Subjects
Details
- ISSN :
- 1758535X and 10795006
- Volume :
- 73
- Database :
- OpenAIRE
- Journal :
- The Journals of Gerontology: Series A
- Accession number :
- edsair.doi.dedup.....6eb952b3df9cabb1c72a7f9d9891ecdd