The association between frailty, care receipt and unmet need for care with the risk of hospital admissions.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 09 02 2024
accepted: 25 06 2024
medline: 27 9 2024
pubmed: 27 9 2024
entrez: 27 9 2024
Statut: epublish

Résumé

Frailty is characterised by a decline in physical, cognitive, energy, and health reserves and is linked to greater functional dependency and higher social care utilisation. However, the relationship between receiving care, or receiving insufficient care among older people with different frailty status and the risk of unplanned admission to hospital for any cause, or the risk of falls and fractures remains unclear. This study used information from 7,656 adults aged 60 and older participating in the English Longitudinal Study of Ageing (ELSA) waves 6-8. Care status was assessed through received care and self-reported unmet care needs, while frailty was measured using a frailty index. Competing-risk regression analysis was used (with death as a potential competing risk), adjusted for demographic and socioeconomic confounders. Around a quarter of the participants received care, of which approximately 60% received low levels of care, while the rest had high levels of care. Older people who received low and high levels of care had a higher risk of unplanned admission independent of frailty status. Unmet need for care was not significantly associated with an increased risk of unplanned admission compared to those receiving no care. Older people in receipt of care had an increased risk of hospitalisation due to falls but not fractures, compared to those who received no care after adjustment for covariates, including frailty status. Care receipt increases the risk of hospitalisation substantially, suggesting this is a group worthy of prevention intervention focus.

Sections du résumé

BACKGROUND BACKGROUND
Frailty is characterised by a decline in physical, cognitive, energy, and health reserves and is linked to greater functional dependency and higher social care utilisation. However, the relationship between receiving care, or receiving insufficient care among older people with different frailty status and the risk of unplanned admission to hospital for any cause, or the risk of falls and fractures remains unclear.
METHODS AND FINDINGS RESULTS
This study used information from 7,656 adults aged 60 and older participating in the English Longitudinal Study of Ageing (ELSA) waves 6-8. Care status was assessed through received care and self-reported unmet care needs, while frailty was measured using a frailty index. Competing-risk regression analysis was used (with death as a potential competing risk), adjusted for demographic and socioeconomic confounders. Around a quarter of the participants received care, of which approximately 60% received low levels of care, while the rest had high levels of care. Older people who received low and high levels of care had a higher risk of unplanned admission independent of frailty status. Unmet need for care was not significantly associated with an increased risk of unplanned admission compared to those receiving no care. Older people in receipt of care had an increased risk of hospitalisation due to falls but not fractures, compared to those who received no care after adjustment for covariates, including frailty status.
CONCLUSIONS CONCLUSIONS
Care receipt increases the risk of hospitalisation substantially, suggesting this is a group worthy of prevention intervention focus.

Identifiants

pubmed: 39331671
doi: 10.1371/journal.pone.0306858
pii: PONE-D-24-05107
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0306858

Informations de copyright

Copyright: © 2024 Maharani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Asri Maharani (A)

National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

David R Sinclair (DR)

National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom.

Andrew Clegg (A)

Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, School of Medicine, University of Leeds, Leeds, United Kingdom.

Barbara Hanratty (B)

National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom.

James Nazroo (J)

Cathie Marsh Institute for Social Research, School of Social Sciences, Faculty of Humanities, University of Manchester, Manchester, United Kingdom.

Gindo Tampubolon (G)

Global Development Institute, University of Manchester, Manchester, United Kingdom.

Chris Todd (C)

National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

Raphael Wittenberg (R)

National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom.

Terence W O'Neill (TW)

National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.

Fiona E Matthews (FE)

National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty / Healthy Ageing, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom.

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Classifications MeSH