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Admissions to inpatient care facilities in the last year of life of community-dwelling older people in Europe

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Abstract
In the last year of life, many older people rather avoid admissions to inpatient care facilities. We describe and compare such admissions in the last year of life of 5092 community-dwelling older people in 15 European countries (+Israel). Proxy-respondents of the older people, who participated in the longitudinal SHARE study, reported on admissions to inpatient care facilities (hospital, nursing home or hospice) during the last year of their life. Multivariable regression analyses assessed associations between hospitalizations and personal/contextual characteristics. The proportion of people who had been admitted at least once to an inpatient care facility in the last year of life ranged from 54% (France) to 76% (Austria, Israel, Slovenia). Admissions mostly concerned hospitalizations. Multivariable analyses showed that especially Austrians, Israelis and Poles had higher chances of being hospitalized. Further, hospitalizations were more likely for those being ill for 6 months or more (OR:1.67, CI:1.39-2.01), and less likely for persons aged 80+ (OR:0.54, CI:0.39-0.74; compared with 48-65 years), females (OR:0.74, CI:0.63-0.89) and those dying of cardiovascular diseases (OR:0.66, CI:0.51-0.86; compared with those dying of cancer). Although healthcare policies increasingly stress the importance that people reside at home as long as possible, admissions to inpatient care facilities in the last year of life are relatively common across all countries. Furthermore, we found a striking variation concerning the proportion of admissions across countries which cannot only be explained by patient needs. It suggests that such admissions are at least partly driven by system-level or cultural factors.
Keywords
DEATH CERTIFICATE DATA, END, COUNTRIES, CANCER, NETHERLANDS, HEALTH, PLACE, HOSPITALIZATION, TRANSITIONS, SETTINGS

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MLA
Overbeek, Anouk, Lieve Van den Block, Ida J Korfage, et al. “Admissions to Inpatient Care Facilities in the Last Year of Life of Community-dwelling Older People in Europe.” EUROPEAN JOURNAL OF PUBLIC HEALTH 27.5 (2017): 814–821. Print.
APA
Overbeek, A., Van den Block, L., Korfage, I. J., Penders, Y. W., van der Heide, A., & Rietjens, J. A. (2017). Admissions to inpatient care facilities in the last year of life of community-dwelling older people in Europe. EUROPEAN JOURNAL OF PUBLIC HEALTH, 27(5), 814–821.
Chicago author-date
Overbeek, Anouk, Lieve Van den Block, Ida J Korfage, Yolanda WH Penders, Agnes van der Heide, and Judith AC Rietjens. 2017. “Admissions to Inpatient Care Facilities in the Last Year of Life of Community-dwelling Older People in Europe.” European Journal of Public Health 27 (5): 814–821.
Chicago author-date (all authors)
Overbeek, Anouk, Lieve Van den Block, Ida J Korfage, Yolanda WH Penders, Agnes van der Heide, and Judith AC Rietjens. 2017. “Admissions to Inpatient Care Facilities in the Last Year of Life of Community-dwelling Older People in Europe.” European Journal of Public Health 27 (5): 814–821.
Vancouver
1.
Overbeek A, Van den Block L, Korfage IJ, Penders YW, van der Heide A, Rietjens JA. Admissions to inpatient care facilities in the last year of life of community-dwelling older people in Europe. EUROPEAN JOURNAL OF PUBLIC HEALTH. 2017;27(5):814–21.
IEEE
[1]
A. Overbeek, L. Van den Block, I. J. Korfage, Y. W. Penders, A. van der Heide, and J. A. Rietjens, “Admissions to inpatient care facilities in the last year of life of community-dwelling older people in Europe,” EUROPEAN JOURNAL OF PUBLIC HEALTH, vol. 27, no. 5, pp. 814–821, 2017.
@article{8545777,
  abstract     = {In the last year of life, many older people rather avoid admissions to inpatient care facilities. We describe and compare such admissions in the last year of life of 5092 community-dwelling older people in 15 European countries (+Israel). 
Proxy-respondents of the older people, who participated in the longitudinal SHARE study, reported on admissions to inpatient care facilities (hospital, nursing home or hospice) during the last year of their life. Multivariable regression analyses assessed associations between hospitalizations and personal/contextual characteristics. 
The proportion of people who had been admitted at least once to an inpatient care facility in the last year of life ranged from 54% (France) to 76% (Austria, Israel, Slovenia). Admissions mostly concerned hospitalizations. Multivariable analyses showed that especially Austrians, Israelis and Poles had higher chances of being hospitalized. Further, hospitalizations were more likely for those being ill for 6 months or more (OR:1.67, CI:1.39-2.01), and less likely for persons aged 80+ (OR:0.54, CI:0.39-0.74; compared with 48-65 years), females (OR:0.74, CI:0.63-0.89) and those dying of cardiovascular diseases (OR:0.66, CI:0.51-0.86; compared with those dying of cancer). 
Although healthcare policies increasingly stress the importance that people reside at home as long as possible, admissions to inpatient care facilities in the last year of life are relatively common across all countries. Furthermore, we found a striking variation concerning the proportion of admissions across countries which cannot only be explained by patient needs. It suggests that such admissions are at least partly driven by system-level or cultural factors.},
  author       = {Overbeek, Anouk and Van den Block, Lieve and Korfage, Ida J and Penders, Yolanda WH and van der Heide, Agnes and Rietjens, Judith AC},
  issn         = {1101-1262},
  journal      = {EUROPEAN JOURNAL OF PUBLIC HEALTH},
  keywords     = {DEATH CERTIFICATE DATA,END,COUNTRIES,CANCER,NETHERLANDS,HEALTH,PLACE,HOSPITALIZATION,TRANSITIONS,SETTINGS},
  language     = {eng},
  number       = {5},
  pages        = {814--821},
  title        = {Admissions to inpatient care facilities in the last year of life of community-dwelling older people in Europe},
  url          = {http://dx.doi.org/10.1093/eurpub/ckx105},
  volume       = {27},
  year         = {2017},
}

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