Factors associated with hospitalization in the period between evaluation and start of long term care

Background The growing number of elderly subjects with functional limitations, cognitive impairment and disability is an organizational challenge for the healthcare sector. This study investigated the factors associated with hospitalization in the period between evaluating the patient and the start of a long term care (LTC) program, while the patients are on a waiting list. Methods A population-based historical cohort study was performed using data extracted from different administrative databases, which were linked by a unique ID number. The cohort included individuals 65 years and older who were evaluated for entrance into an LTC program between January 1, 2012 and December 31, 2013 in Tuscany, Italy. Poisson regression was used to estimate the Incidence Rate Ratios (IRR) of hospitalization in the waiting period. Results The sample consisted of 11,498 subjects (mean age 83.7 years), of whom 10.5% was hospitalize during the follow up. The characteristics positively associated with hospital admission were Residence zone [urban IRR 0.88 (95% confidence interval 0.77-1.00)], number of drugs IRR 1.01 (95% confidence interval 1.00-1.02) and Charlson scores [Charlson score 1 IRR 1.20 (95% confidence interval 1.03-1.39) and Charlson score 2 IRR 1.40 (95% confidence interval 1.22-1.60)].)] . Rates of hospitalization for patients with heart failure, chronic obstructive pulmonary disease (COPD) and dementia were higher than for other chronic diseases. Conclusions Our preliminary results indicate that it may be possible to predict the risk factors that can lead to hospitalization. This study will produce list of variables that could be considered for assigning priority during the evaluation process. Key message: The recognition of patient characteristics that increase the risk of hospitalization before the start of a LTC program may help those involved in multidimensional evaluation to assign priority