Social characteristic and dynamic of their changes during 25 years in the acute inpatient geriatric ward

Czech version

Authors: Pavel Weber; Hana Meluzínová; Vlasta Polcarová; Hana Matějovská Kubešová; Dana Weberová; Katarína Bielaková
Authors‘ workplace: Klinika interní, geriatrie a praktického lékařství LF MU a FN Brno
Published in: Geriatrie a Gerontologie 2021, 10, č. 3: 160-166
Category: Original Article

Overview

Aim: Older people are an extremely heterogeneous group of people with different manifestations in the biological, mental and social spheres.

Methodology: A retrospective cohort study focused on analyzing and comparing the data collected over 25 years. The monitored parameters were age, mean length of hospital stay, social status and the form of termination of hospitalization. Between 1995 and 2020, we treated a total of 28,238 elderly patients (≥65 years; range 65–105 years) who were hospitalized in the acute geriatric ward. There were a total of 18,066 – ie 64 % women (age 81.7±7.7 years) and 10,172 men – ie 36 % (age 79.0±7.6 years).

Results: The age difference between the two groups was statistically significant (t = 24.418; p <0.01). On average, hospitalized women were almost 3 years older than men. For men, the average age of hospitalizations increases, while for women there is a slight decrease over 25 years. The median length of hospital stay for both sexes tends to decrease significantly from the original 15–17 days to the current 9.5 days. The number of hospitalized younger seniors (65–74 years) is declining, while the oldest seniors (85 years and older) are on the rise for both sexes. Social status shows that for men, the proportion of married people among the hospitalized is rising while the number of widowers is decreasing. The trend of a decrease in exits and translations to a long term care facility is evident, while the trend of men dismissed home is experiencing a significant increase. The situation with translations to other acute departments and transfers to social facilities has been relatively stable for 25 years.

Conclusion: Our data point to the importance of monitoring these parameters and the indivisible integrity of health and social issues in the elderly.

Keywords:

geriatrization of medicine – Social status – seniorization of the population – acute hospitalization of elderly people – loneliness – transfers and termination of hospitalization.

Sources

Fillit HM, Rockwood K, Young JB. Brocklehurst‘s Textbook of Geriatric Medicine and Gerontology. Philadelphia: Elsevier Health Sciences 2016.
Lesley KB, James DP, Kunal S, et al. Oxford Handbook of Geriatric Medicine, Third Edition. Oxford University Press, UK 2019.
Weber P. Stárnutí staré společnosti (seniorizace) a geriatrizace medicíny. Geri a gero 2018; 7(4): 152–155.
D‘Amen B, Socci M, Santini S. Intergenerational caring: a systematic literature review on young and young adult caregivers of older people. BMC Geriatr 2021; 21(1): 105.
Zarulli V, Jones JAB, Oksuzyan A, et al. Women live longer than men even during severe famines and epidemics. PNAS 2018; 115(4): E832–E840.
Crimmins EM, Shim H, Zhang YS, Kim JK. Differences between Men and Women in Mortality and the Health Dimensions of the Morbidity Process. Clin Chem 2019; 65(1): 135–145.
Ferdousi N. State responsibility in caring for elderly people. Int J Growth Dev 2017; 1(1): 23.
Jain Sachin H. All Health Care Is Social: The Increasing Significance Of Social Interaction And Health. www.forbes.com › sites › sachinjain › 2018/04/30
Umberson D, Montez JF. Social relationships and health: a flashpoint for health policy. J Health Soc Behav 2010; 51 Suppl: S54–S66.
Lindwall L, Lohne V. Human dignity research in clinical practice – a systematic literature review. Scand J Caring Sci 2020; Oct 26.
Ounalli H, Mamo D, Testoni I, et als. Improving Dignity of Care in Community-Dwelling Elderly Patients with Cognitive Decline and Their Caregivers. The Role of Dignity Therapy. Behav Sci (Basel) 2020;10 (12):178.
Smailhodzic E, Hooijsma W, Boonstra A and Langley DJ. Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals. BMC Health Serv Res 2016; 16: 442.
Kastner M, Cardoso R, Lai Y, et al. Effectiveness of interventions for managing multiple high–burden chronic diseases in older adults: a systematic review and meta–analysis. CMAJ 2018; 190(34): E1004–E1012.
Pathy MS John, Finucane P (eds.). Geriatric Medicine: Problems and Practice paperback. NY: Springer 2014.
Frost R, Belk C, Jovicic A, et al. Health promotion interventions for community-dwelling older people with mild or pre-frailty: a systematic review and meta-analysis. BMC Geriatr 2017; 17(1): 157.
Hoel RW. Polypharmacy Management in Older Patients. Mayo Clin Proc 2021; 96(1): 242–256.
Rutenberg AD, Mitnitski AB, Farrell SG, Rockwood K. Unifying aging and frailty through complex dynamical networks. Exp Gerontol 2018; 107: 126–129.
Swartz K. Searching for a Balance of Responsibilities: OECD Countries’ Changing Elderly Assistance Policies. Annu Rev Public Health 2013; 34: 397–412.
Stoddart KM. Social meanings and understandings in patient–nurse interaction in the community practice setting: a grounded theory study. BMC Nurs 2012; 11: 14.
Nooijen CFJ, Blom V, Ekblom O, et al. The effectiveness of multi-component interventions targeting physical activity or sedentary behaviour amongst office workers: a three-arm cluster randomised controlled trial. BMC Public Health 2020; 20(1): 1329.
Han Chad Yixian, Miller M, Yaxley A, et al. Effectiveness of combined exercise and nutrition interventions in prefrail or frail older hospitalised patients: a systematic review and meta-analysis. BMJ Open 2020; 10(12): e040146.
Jørgensen R, Brabrand M. Screening of the frail patient in the emergency department: A systematic review. Eur J Intern Med 2017; 45: 71–73.
Morley JE, Vellas B, van Kan GA, Anker SD, et al. Frailty consensus: a call to action. J Am Med Dir Assoc 2013; 14(6): 392–397.
Social isolation is a significant contributor to morbidity and early mortality. Greater prioritization of intervention science and policy is needed to address the public health burden. June 2020 | health affairs. www.healthaffairs.org/briefs.
Rodríguez-Romero R, Herranz-Rodríguez C, Kostov B, Gené-Badia J, Sisó-Almirall A. Intervention to reduce perceived loneliness in community-dwelling older people. Scand J Caring Sci 2021; 35(2): 366–374.
MR-FIT. Multiple risk factor intervention trial. Risk factor changes and mortality results. Multiple Risk Factor Intervention Trial Research Group. JAMA 1982; 248(12): 1465–1477.
Balsa A. Social interactions in health behaviors and conditions. https://ideas.repec.org › mnt › wpaper.
Takahashi PY, Leppin AL, Hanson GJ. Hospital to Community Transitions for Older Adults: An Update for the Practicing Clinician.
van Vuuren J, Thomas B, Agarwal G, et al. Reshaping healthcare delivery for elderly patients: the role of community paramedicine; a systematic review. BMC Health Serv Res 2021; 21(1): 29.
Berkeley B. Relationship between Health Provider Status and Social Interaction. Open Access Library Journal 2017; 4: 1–7.
Comer A, Fettig L, Torke AM. Identifying Goals of Care. Med Clin North Am 2020; 104(5): 767–775.
Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004; 59 (3): 255–263.