Effects of Mobility and Multimorbidity on Inpatient and Postacute Health Care Utilization
This study examines effects of mobility and multimorbidity on hospitalization and inpatient and postacute care (PAC) facility days among older men. Prospective study of 1,701 men (mean age 79.3 years) participating in Osteoporotic Fractures in Men (MrOS) Study Year 7 (Y7) examination (2007-2008) lin...
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| Veröffentlicht in: | The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2018-09, Vol.73 (10), p.1343-1349 |
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| creator | Ensrud, Kristine E Lui, Li-Yung Langsetmo, Lisa Vo, Tien N Taylor, Brent C Cawthon, Peggy M Kilgore, Meredith L McCulloch, Charles E Cauley, Jane A Stefanick, Marcia L Yaffe, Kristine Orwoll, Eric S Schousboe, John T |
| description | This study examines effects of mobility and multimorbidity on hospitalization and inpatient and postacute care (PAC) facility days among older men.
Prospective study of 1,701 men (mean age 79.3 years) participating in Osteoporotic Fractures in Men (MrOS) Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high. Hospitalizations and PAC facility stays ascertained during 12 months following Y7.
Reduced mobility and greater multimorbidity burden were independently associated with a higher risk of inpatient and PAC facility utilization, after accounting for each other and traditional indicators. Adjusted mean total facility days per year were 1.13 (95% confidence interval [CI] = 0.74-1.40) among men with good mobility increasing to 2.43 (95% CI = 1.17-3.84) among men with poor mobility, and 0.67 (95% CI = 0.38-0.91) among men without multimorbidity increasing to 2.70 (95% CI = 1.58-3.77) among men with high multimorbidity. Men with poor mobility and high multimorbidity had a ninefold increase in mean total facility days per year (5.50, 95% CI = 2.78-10.87) compared with men with good mobility without multimorbidity (0.59, 95% CI = 0.37-0.95).
Among older men, mobility limitations and multimorbidity were independent predictors of higher inpatient and PAC utilization after considering each other and conventional predictors. Marked combined effects of reduced mobility and multimorbidity burden may be important to consider in clinical decision-making and planning health care delivery strategies for the growing aged population. |
| doi_str_mv | 10.1093/gerona/glx128 |
| format | Article |
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Prospective study of 1,701 men (mean age 79.3 years) participating in Osteoporotic Fractures in Men (MrOS) Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high. Hospitalizations and PAC facility stays ascertained during 12 months following Y7.
Reduced mobility and greater multimorbidity burden were independently associated with a higher risk of inpatient and PAC facility utilization, after accounting for each other and traditional indicators. Adjusted mean total facility days per year were 1.13 (95% confidence interval [CI] = 0.74-1.40) among men with good mobility increasing to 2.43 (95% CI = 1.17-3.84) among men with poor mobility, and 0.67 (95% CI = 0.38-0.91) among men without multimorbidity increasing to 2.70 (95% CI = 1.58-3.77) among men with high multimorbidity. Men with poor mobility and high multimorbidity had a ninefold increase in mean total facility days per year (5.50, 95% CI = 2.78-10.87) compared with men with good mobility without multimorbidity (0.59, 95% CI = 0.37-0.95).
Among older men, mobility limitations and multimorbidity were independent predictors of higher inpatient and PAC utilization after considering each other and conventional predictors. Marked combined effects of reduced mobility and multimorbidity burden may be important to consider in clinical decision-making and planning health care delivery strategies for the growing aged population.</description><identifier>ISSN: 1079-5006</identifier><identifier>EISSN: 1758-535X</identifier><identifier>DOI: 10.1093/gerona/glx128</identifier><identifier>PMID: 28645202</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject><![CDATA[Aged ; Aged, 80 and over ; Aging - physiology ; Algorithms ; Cohort Studies ; Comorbidity ; Editor's Choice ; Effects ; Health care ; Health services utilization ; Hospitalization - statistics & numerical data ; Humans ; Independent Living - statistics & numerical data ; Inpatient care ; Inpatients - statistics & numerical data ; Length of Stay - statistics & numerical data ; Male ; Medicare - statistics & numerical data ; Mobility ; Mobility Limitation ; Morbidity ; Multimorbidity ; Patient Acceptance of Health Care - statistics & numerical data ; Prospective Studies ; Risk Factors ; Subacute Care - statistics & numerical data ; The Journal of Gerontology: Medical Sciences ; United States]]></subject><ispartof>The journals of gerontology. Series A, Biological sciences and medical sciences, 2018-09, Vol.73 (10), p.1343-1349</ispartof><rights>Copyright Oxford University Press Oct 2018</rights><rights>Published by Oxford University Press on behalf of The Gerontological Society of America 2017. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-af682dd70ec7d3ef8144dc925ee085240f3f5f5d1077dae3a1786f791f497f1f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28645202$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ensrud, Kristine E</creatorcontrib><creatorcontrib>Lui, Li-Yung</creatorcontrib><creatorcontrib>Langsetmo, Lisa</creatorcontrib><creatorcontrib>Vo, Tien N</creatorcontrib><creatorcontrib>Taylor, Brent C</creatorcontrib><creatorcontrib>Cawthon, Peggy M</creatorcontrib><creatorcontrib>Kilgore, Meredith L</creatorcontrib><creatorcontrib>McCulloch, Charles E</creatorcontrib><creatorcontrib>Cauley, Jane A</creatorcontrib><creatorcontrib>Stefanick, Marcia L</creatorcontrib><creatorcontrib>Yaffe, Kristine</creatorcontrib><creatorcontrib>Orwoll, Eric S</creatorcontrib><creatorcontrib>Schousboe, John T</creatorcontrib><creatorcontrib>Osteoporotic Fractures in Men (MrOS) Study Group</creatorcontrib><creatorcontrib>Osteoporotic Fractures in Men (MrOS) Study Group</creatorcontrib><title>Effects of Mobility and Multimorbidity on Inpatient and Postacute Health Care Utilization</title><title>The journals of gerontology. Series A, Biological sciences and medical sciences</title><addtitle>J Gerontol A Biol Sci Med Sci</addtitle><description>This study examines effects of mobility and multimorbidity on hospitalization and inpatient and postacute care (PAC) facility days among older men.
Prospective study of 1,701 men (mean age 79.3 years) participating in Osteoporotic Fractures in Men (MrOS) Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high. Hospitalizations and PAC facility stays ascertained during 12 months following Y7.
Reduced mobility and greater multimorbidity burden were independently associated with a higher risk of inpatient and PAC facility utilization, after accounting for each other and traditional indicators. Adjusted mean total facility days per year were 1.13 (95% confidence interval [CI] = 0.74-1.40) among men with good mobility increasing to 2.43 (95% CI = 1.17-3.84) among men with poor mobility, and 0.67 (95% CI = 0.38-0.91) among men without multimorbidity increasing to 2.70 (95% CI = 1.58-3.77) among men with high multimorbidity. Men with poor mobility and high multimorbidity had a ninefold increase in mean total facility days per year (5.50, 95% CI = 2.78-10.87) compared with men with good mobility without multimorbidity (0.59, 95% CI = 0.37-0.95).
Among older men, mobility limitations and multimorbidity were independent predictors of higher inpatient and PAC utilization after considering each other and conventional predictors. Marked combined effects of reduced mobility and multimorbidity burden may be important to consider in clinical decision-making and planning health care delivery strategies for the growing aged population.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging - physiology</subject><subject>Algorithms</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Editor's Choice</subject><subject>Effects</subject><subject>Health care</subject><subject>Health services utilization</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Independent Living - statistics & numerical data</subject><subject>Inpatient care</subject><subject>Inpatients - statistics & numerical data</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicare - statistics & numerical data</subject><subject>Mobility</subject><subject>Mobility Limitation</subject><subject>Morbidity</subject><subject>Multimorbidity</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Subacute Care - statistics & numerical data</subject><subject>The Journal of Gerontology: Medical Sciences</subject><subject>United States</subject><issn>1079-5006</issn><issn>1758-535X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtrGzEUhUVpaJy0y27LQDfdTKLHaKTZFIrJCxKSRQPJSsijK1tmLLmSJjT59ZFjJ6S9G110Pw7ncBD6SvARwR07nkMMXh_Ph7-Eyg9oQgSXNWf87mPZsehqjnG7jw5SWuLNcPoJ7VPZNpxiOkH3J9ZCn1MVbHUVZm5w-bHS3lRX45DdKsSZM5uv4KsLv9bZgc8v95uQsu7HDNU56CEvqqmOUN3movBUsOA_oz2rhwRfdu8huj09-T09ry-vzy6mvy7rviE819q2khojMPTCMLCSNI3pO8oBsOS0wZZZbrkpWYTRwDQRsrWiI7bphCWWHaKfW931OFuB6YvBqAe1jm6l46MK2ql_L94t1Dw8qJYwSogsAj92AjH8GSFltXKph2HQHsKYFOkIY10jqSjo9__QZRijL_EUJYxjWXx1haq3VB9DShHsmxmC1aY0tS1NbUsr_Lf3Cd7o15bYM-UGll0</recordid><startdate>20180911</startdate><enddate>20180911</enddate><creator>Ensrud, Kristine E</creator><creator>Lui, Li-Yung</creator><creator>Langsetmo, Lisa</creator><creator>Vo, Tien N</creator><creator>Taylor, Brent C</creator><creator>Cawthon, Peggy M</creator><creator>Kilgore, Meredith L</creator><creator>McCulloch, Charles E</creator><creator>Cauley, Jane A</creator><creator>Stefanick, Marcia L</creator><creator>Yaffe, Kristine</creator><creator>Orwoll, Eric S</creator><creator>Schousboe, John T</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180911</creationdate><title>Effects of Mobility and Multimorbidity on Inpatient and Postacute Health Care Utilization</title><author>Ensrud, Kristine E ; Lui, Li-Yung ; Langsetmo, Lisa ; Vo, Tien N ; Taylor, Brent C ; Cawthon, Peggy M ; Kilgore, Meredith L ; McCulloch, Charles E ; Cauley, Jane A ; Stefanick, Marcia L ; Yaffe, Kristine ; Orwoll, Eric S ; Schousboe, John T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-af682dd70ec7d3ef8144dc925ee085240f3f5f5d1077dae3a1786f791f497f1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging - physiology</topic><topic>Algorithms</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Editor's Choice</topic><topic>Effects</topic><topic>Health care</topic><topic>Health services utilization</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Independent Living - statistics & numerical data</topic><topic>Inpatient care</topic><topic>Inpatients - statistics & numerical data</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicare - statistics & numerical data</topic><topic>Mobility</topic><topic>Mobility Limitation</topic><topic>Morbidity</topic><topic>Multimorbidity</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Subacute Care - statistics & numerical data</topic><topic>The Journal of Gerontology: Medical Sciences</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ensrud, Kristine E</creatorcontrib><creatorcontrib>Lui, Li-Yung</creatorcontrib><creatorcontrib>Langsetmo, Lisa</creatorcontrib><creatorcontrib>Vo, Tien N</creatorcontrib><creatorcontrib>Taylor, Brent C</creatorcontrib><creatorcontrib>Cawthon, Peggy M</creatorcontrib><creatorcontrib>Kilgore, Meredith L</creatorcontrib><creatorcontrib>McCulloch, Charles E</creatorcontrib><creatorcontrib>Cauley, Jane A</creatorcontrib><creatorcontrib>Stefanick, Marcia L</creatorcontrib><creatorcontrib>Yaffe, Kristine</creatorcontrib><creatorcontrib>Orwoll, Eric S</creatorcontrib><creatorcontrib>Schousboe, John T</creatorcontrib><creatorcontrib>Osteoporotic Fractures in Men (MrOS) Study Group</creatorcontrib><creatorcontrib>Osteoporotic Fractures in Men (MrOS) Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The journals of gerontology. Series A, Biological sciences and medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ensrud, Kristine E</au><au>Lui, Li-Yung</au><au>Langsetmo, Lisa</au><au>Vo, Tien N</au><au>Taylor, Brent C</au><au>Cawthon, Peggy M</au><au>Kilgore, Meredith L</au><au>McCulloch, Charles E</au><au>Cauley, Jane A</au><au>Stefanick, Marcia L</au><au>Yaffe, Kristine</au><au>Orwoll, Eric S</au><au>Schousboe, John T</au><aucorp>Osteoporotic Fractures in Men (MrOS) Study Group</aucorp><aucorp>Osteoporotic Fractures in Men (MrOS) Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Mobility and Multimorbidity on Inpatient and Postacute Health Care Utilization</atitle><jtitle>The journals of gerontology. Series A, Biological sciences and medical sciences</jtitle><addtitle>J Gerontol A Biol Sci Med Sci</addtitle><date>2018-09-11</date><risdate>2018</risdate><volume>73</volume><issue>10</issue><spage>1343</spage><epage>1349</epage><pages>1343-1349</pages><issn>1079-5006</issn><eissn>1758-535X</eissn><abstract>This study examines effects of mobility and multimorbidity on hospitalization and inpatient and postacute care (PAC) facility days among older men.
Prospective study of 1,701 men (mean age 79.3 years) participating in Osteoporotic Fractures in Men (MrOS) Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high. Hospitalizations and PAC facility stays ascertained during 12 months following Y7.
Reduced mobility and greater multimorbidity burden were independently associated with a higher risk of inpatient and PAC facility utilization, after accounting for each other and traditional indicators. Adjusted mean total facility days per year were 1.13 (95% confidence interval [CI] = 0.74-1.40) among men with good mobility increasing to 2.43 (95% CI = 1.17-3.84) among men with poor mobility, and 0.67 (95% CI = 0.38-0.91) among men without multimorbidity increasing to 2.70 (95% CI = 1.58-3.77) among men with high multimorbidity. Men with poor mobility and high multimorbidity had a ninefold increase in mean total facility days per year (5.50, 95% CI = 2.78-10.87) compared with men with good mobility without multimorbidity (0.59, 95% CI = 0.37-0.95).
Among older men, mobility limitations and multimorbidity were independent predictors of higher inpatient and PAC utilization after considering each other and conventional predictors. Marked combined effects of reduced mobility and multimorbidity burden may be important to consider in clinical decision-making and planning health care delivery strategies for the growing aged population.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>28645202</pmid><doi>10.1093/gerona/glx128</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Aging - physiology Algorithms Cohort Studies Comorbidity Editor's Choice Effects Health care Health services utilization Hospitalization - statistics & numerical data Humans Independent Living - statistics & numerical data Inpatient care Inpatients - statistics & numerical data Length of Stay - statistics & numerical data Male Medicare - statistics & numerical data Mobility Mobility Limitation Morbidity Multimorbidity Patient Acceptance of Health Care - statistics & numerical data Prospective Studies Risk Factors Subacute Care - statistics & numerical data The Journal of Gerontology: Medical Sciences United States |
| title | Effects of Mobility and Multimorbidity on Inpatient and Postacute Health Care Utilization |
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