Abstract
BackgroundPlanning population care in a specific health care setting requires deep knowledge of the clinical characteristics of the target care recipients, which tend to be country specific. Our area virtually lacks any descriptive, far-reaching publications about institutionalized older people (IOP). We aimed to investigate the demographic and clinical characteristics of institutionalized older people (IOP) ≥65 years old and compare them with those of the rest of the population of the same age.MethodsRetrospective analysis (total cohort approach) of clinical and resource-use characteristics of IOP and non-IOP older than 65 years in Catalonia (North-East Spain). Variables analysed included age and sex, diagnoses, morbidity burden—using Adjusted Morbidity Groups (GMA, Grupos de Morbilidad Ajustada)—, mortality, use of resources, and medications taken. All data were obtained from the administrative database of the local healthcare system.ResultsThis study included 93,038, 78,458, 68,545 and 67,456 IOP from 2011, 2013, 2015 and 2017, respectively. In this interval, an increase in median age (83 vs. 87 years), in women (68.64% vs. 72.11%) and in annual mortality (11.74% vs. 20.46%) was observed. Compared with non-IOP (p < 0.001 in all comparisons), IOP showed a higher annual mortality (20.46% vs. 3.13%), a larger number of chronic diseases (specially dementia: 46.47% vs. 4.58%), higher multimorbidity (15.2% vs. 4.2% with GMA of maximum complexity), and annual admissions to acute care (47.6% vs. 27.7%) and skilled nursing facilities (27.8% vs. 7.4%), mean length of hospital stay (10.0 vs. 7.2 days) and mean of medications taken (11.7 vs. 8.0).ConclusionsThere is a growing gap between the clinical and demographic characteristics of age-matched IOP and non-IOP, which overlaps with a higher mortality rate of IOP. The profile of resources utilization of IOP compared with non-IOP strongly suggests a deficiency of preventive actions and stresses the need to rethink the care model for IOP from a social and health care perspective.
Highlights
Planning population care in a specific health care setting requires deep knowledge of the clinical characteristics of the target care recipients, which tend to be country specific
Within the context of this study, and based on the consensus of the “Integrated medical care model for older people residing in nursing homes”, promoted by the local health authorities, the term “nursing home” was defined as any permanent or temporary place for people ≥65 years that do not have a sufficient degree of autonomy to perform daily activities, need constant supervision and live in a social-family situation requiring the replacement of their home
Evolution of epidemiological and clinical characteristics of older people institutionalized in nursing homes During the seven-year interval analysed (2011–2017), the number of institutionalized older people (IOP) tended to decrease, with a 27.5% reduction
Summary
Planning population care in a specific health care setting requires deep knowledge of the clinical characteristics of the target care recipients, which tend to be country specific. Based on the data available, during the first decade of the twenty-first century, there was a 150% increase in the number of nursing home beds, going from 37,281 in 2000 to 93,038 in 2011 in Catalonia [3]. This trend has been observed in most European countries, it seems to have stabilized after 2011 [4]. International evidence suggest that the sociodemographic profile of institutionalized people has evolved in the last decades alongside the demographic shift [7, 8] These trends cannot be confirmed in many countries that―like Spain―lack data from care facilities. The absence of quantitative data on the type and extent of resource utilization of residents admitted to care facilities in our area leaves policymakers with little options other than models from other countries (often heterogeneous in terminology and type of healthcare provided) to plan service provision in this setting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
