Journal Information
Vol. 14. Issue 5.
Pages 363-370 (September - October 2000)
Vol. 14. Issue 5.
Pages 363-370 (September - October 2000)
Open Access
Factores de riesgo de ingreso hospitalario en mayores de 64 años
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A. Pérez Martín1,
Corresponding author
aperezm@cht.insalud.es

Dr. Pérez Martín. Hospital Geriátrico Virgen del Valle. Crta. Cobisa, s/n. 45071 Toledo.
, F.J. García García1, E. Martín Correa1, L. Romero Rizos1, M.J. Rodríguez Barquero1, I. Echevarría Santamaría1, C. García Colmenero2
1 Sección de Geriatría. Hospital Geriátrico Virgen del Valle. Complejo Hospitalario de Toledo
2 Sección de Información Sanitaria y Vigilancia Epidemiológica. Delegación Provincial de Sanidad de Toledo. Junta de Comunidades de Castilla la Mancha
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Resumen
Objetivo

Determinar los factores asociados al ingreso hospitalario en una muestra representativa de la población mayor de 64 años.

Diseño y participantes

Estudio de cohorte sobre una muestra de 3.214 sujetos representativa de la población de 65 y más años del partido judicial de Toledo (Castilla-La Mancha).

Método

Entrevista personal en el domicilio del sujeto donde se recogen: datos sociodemográficos, carga de enfermedad, situación funcional en actividades de autocuidado e instrumentales, presencia de deterioro cognitivo y trastorno del ánimo, salud autopercibida y utilización previa de recursos sanitarios. Se analiza la presencia de ingreso hospitalario en los 12 meses que siguen a la entrevista en cualquiera de los tres hospitales que atienden el mencionado área.

Resultados

342 (10,6%) de los sujetos ingresaron en una ocasión al menos en el año siguiente a la realización de la entrevista. En el modelo logístico resultaron factores de riesgo de ingreso hospitalario: la edad avanzada (OR: 1,02), el sexo masculino (OR: 1,37), la presencia de cardiopatía (OR: 1,97) o broncopatía (OR: 1,57), el déficit visual incapacitante (OR: 1,88), la pobre salud autopercibida (OR: 1,37), la dependencia en actividades de autocuidado (OR: 1,45) y haber utilizado previamente el hospital (OR: 3,45). La ingesta de alcohol resultó un factor protector (OR: 0,70).

Conclusiones

Las circunstancias asociadas a precisar ingreso hospitalario son multifactoriales. El ingreso anterior es el factor de riesgo de mayor magnitud a la hora de predecir una nueva admisión.

Palabras clave:
Envejecimiento
Hospitalización
Factores de riesgo
Servicios de salud
Summary
Objective

To determine factors associated with hospitalization in a representative sample of population older than 64 years.

Design and participants

Cohort study on a sample of 3,214 representative subjects of the population 65 years and older from the judicial district of Toledo (Spain).

Method

Personal home interview collecting data on: sociodemographic factors, comorbidity, basic and instrumental activities of daily life, congitive decline and depressive disorder, self-rated health and previous use of health services. Hospital discharge in the 12-month period after the interview in anyone of the three hospitals in the stady area were analyzed.

Results

342 (10,6%) of the subjects spent at least one night in the hospital in the year after the accomplishment of the interview. Risk factors for hospitalization in the logistical model were: advanced age (OR: 1,02), male sex (OR: 1,37), presence of cardiopathy (OR: 1,97) or chronic obstruction to airflow (OR: 1,57), visual deficit (OR: 1,88), worse self-rated health (OR: 1,37) and having used the hospital previously (OR: 3,45). Alcohol consumption was a protective factor (OR: 0,70).

Conclusions

Risk factors for hospitalization are of diverse origin. The previous admission is the strongest predicitive factor for new hospitalization.

Key words:
Aged
Hospitalization
Risk factors
Health services
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Bibliografía
[1.]
F. Wolinsky, S.D. Culler, C.M. Callahan, R.J. Johnson.
Hospital resource consumption among older adults: a prospective analysis of episodes, length of stay, and charges over a seven-year period.
J Gerontol, 49 (1994), pp. S240-S252
[2.]
J.D. Freedman, A. Beck, B. Robertson, B.N. Calong, G. Gade.
Using a mailed survey to predict hospital admission among patients older than 80.
J Am Geriatr Soc, 44 (1996), pp. 689-692
[3.]
E.A. Coleman, E.H. Wagner, L.C. Grothaus, J. Hecht, J. Savarino, D.M. Buchner.
Predicting hospitalization and functional decline in older health plan enrollees: are administrative data as accurate as self-reoport?.
J Am Geriatr Soc, 46 (1998), pp. 419-425
[4.]
R.M. Andersen.
A behavioral model of families’ use of health services.
Center for Health Administration Services, (1968),
[5.]
L.A. Aday, R. Andersen.
A framework for the study of access to medical care.
Health Serv Res, 9 (1974), pp. 208-220
[6.]
D.M. Steinwachs.
Application of health status assessment measures in policy research.
Med Care, 27 (1989), pp. S12-S26
[7.]
L. Branch, A. Jette, C. Evashwick, M. Polansky, G. Rowe, P. Diehr.
Toward understanding elders’ health service utilization.
J Community Health, 7 (1981), pp. 80-92
[8.]
C.M. Ashton, N.J. Petersen, J. Souchek, T.J. Menke, H.J. Yu, K. Pietz, M.L. Eigenbrodt, et al.
Geographic Variations In Utilization Rates In Veterans Affairs Hospitals And Clinics.
N Engl J Med, 340 (1999), pp. 32-39
[9.]
L.C. Silva Aycaguer.
Muestreo para la investigación en Ciencias de la Salud. Madrid. Ed.
Díaz de Santos SA, (1993),
[10.]
Duke University Center for the Study of aging and Human development.
Multifunctional assessment: The OARS methodology.
Duke University, (1978),
[11.]
P. Eiroa Patiño, F.L. Vazquez-Vizoso, R. Veras Castro.
Discapacidades y necesidades de servicios en las personas mayores detectadas en la encuesta de salud OARS-Vigo.
Med Clin (Barc), 106 (1996), pp. 641-648
[12.]
S. Katz, A.B. Ford, R.W. Moskowitz, B.A. Jackson, M.W. Jaffe.
Studies of illnes in the aged. The index of ADL: A standarizaded measure of biological and psychosocial function.
JAMA, 185 (1963), pp. 94-98
[13.]
M.P. Lawton.
Assessing the competence of older people. In Research planning and action for the elderly.
[14.]
R.A. Kane.
Measures of physical functioning in long-term care. En Assessing the elderly.
The Rand Corporation, pp. 29-65
[15.]
M.F. Folstein, S. Folstein, P.R. McHugh.
Mini-Mental State: a practical method for grading the cognitive state of patients for clinicians.
J Psychiatr Res, 12 (1975), pp. 189-198
[16.]
M.V. Escribano Aparicio, M. Pérez Dively, F.J. García García, A. Pérez Martín, L. Romero, et al.
Validación del MMSE de Folstein en una población española de bajo nivel educativo.
Rev Esp Geriatr Gerontol, 34 (1999), pp. 319-326
[17.]
J.A. Yesavage, T.L. Brink, T.L. Rose, O. Lum, V. Huang, et al.
Development and validation of a geriatric depression scale: a preliminary report.
J Psychiatr Res, 17 (1982-83), pp. 37-49
[18.]
INSALUD.
Encuesta nacional de salud.
Ministerio de Sanidad y Consumo, (1995),
[19.]
M.N. Hann, J.E. Selby, C.P. Quesenberry, J.A. Schmittdiel, B.H. Fireman, et al.
The impact of aging and chronic disease on use of hospital and outpatient services in a large HMO: 1971-1991.
J Am Geriatr Soc, 45 (1997), pp. 667-674
[20.]
L.D. Ried, R.E. Johnson, K.K. Brody, T.M. Vogt.
Medical care utilization among older HMO members with and without hypertension.
J Am Geriatr Soc, 43 (1995), pp. 222-229
[21.]
C. Boult, B. Dowd, D. Mccaffrey, L. Boult, R. Hernandez, H. Krulewicth.
Screening elders for risk of hospital admission.
J Am Geriatr Soc, 41 (1993), pp. 811-817
[22.]
N.P. Roos, L.L. Roos, J. Mossey, B. Havens.
Using administrative database to predict important health outcomes: entry to hospital, nursing home and death.
Med Care, 26 (1988), pp. 221-239
[23.]
G.F. Anderson, E.P. Steinberg.
Hospital readmissions in the Medicare population.
N Engl J Med, 31 (1984), pp. 349-353
[24.]
J.M. Mossey, E. Shapiro.
Self-rated health: a predictor of mortality among the elderly.
Am J Public Health, 72 (1982), pp. 800-808
[25.]
C.D. Murlow, M.B. Gerety, J.E. Cornell, V.A. Lawrence, D.N. Kanten.
The relationship between disease and function and perceived health in very frail elders.
J Am Geriatr Soc, 42 (1994), pp. 374-380
[26.]
D.K. Freeborn, C.R. Pope, J.P. Mullooly, B.H. McFarland.
Consistently high users of medical care among the elderly.
Med Care, 28 (1990), pp. 527-540
[27.]
a.l. Siu, D.B. reuben, J.G. Ouslander, D. Osterweil.
Using multidimensional health measures in older persons to identify risk of hospitalization and skilled nursing placement.
Qual Life Res, 2 (1993), pp. 253-269
[28.]
C.S. Blaum, J. Liang, X. Liu.
The relationship of chronic diseases and health status to health services uitlization of older americans.
J Am Geriatr Soc, 42 (1994), pp. 1087-1093
[29.]
R. Burns, L.O. Nichols.
Factors predicting readmission of older general medicine patients.
J Gen Intern Med, 6 (1991), pp. 389-393
[30.]
J.I. González Montalvo, J.J. Baztan, L. Rodríguez Mañas, E. San Cristóbal, A. Gato, et al.
Ingreso hospitalario urgente en servicios médicos: causas, justificación, factores sociales y sus diferencias en función de la edad.
Med Clin (Barc), 103 (1994), pp. 441-444
[31.]
J.M. Cusker, E. Healey, F. Bellavance, B. Connolly.
Predictors of repeat emergency department visits by elders.
Acad Emerg Med, 4 (1997), pp. 581-588
[32.]
T.R. Fried, V. Mor.
Frailty and hospitalization of long-term stay nursing home residents.
J Am Geriatr Soc, 45 (1997), pp. 265-269
[33.]
S.C. Stearns, M.G. Kovar, K. Hayes, G.G. Koch.
Risk indicators for hospitalization during the last year of life.
Health Serv Res, 31 (1996), pp. 49-69
[34.]
K.K. Brody, R.J. Jonhson, L.D. Ried.
Evaluation of a self-report screening instrument to predict frailty outcomes in aging populations.
Gerontologist, 37 (1997), pp. 182-191
[35.]
V. Mor, V. Wilcox, W. Rakowski, J. Hiris.
Functional transitions among the elderly: patterns, predictors and related hospital use.
Am J Public Health, 84 (1994), pp. 1274-1280
[36.]
J.M. Borrás.
La utilizació dels serveis sanitaris.
Gac Sanit, 8 (1994), pp. 30-49
[37.]
M. Heliovaara, A. Aromaa, T. Klaukka, M. Joukamaa, O. Impivaara.
Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey.
J Clin Epidemiol, 46 (1993), pp. 181-191

El presente trabajo se ha realizado con el apoyo de la beca FISS n°. 94/1274 y de la Consejería de Sanidad y Bienestar Social de la Junta de Comunidades de Castilla la Mancha n.° 95214.

Copyright © 2000. Sociedad Española de Salud Pública y Administración Sanitaria
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