Health behaviours and potentially preventable hospitalisation: a prospective study of older Australian adults

PLoS One. 2014 Apr 1;9(4):e93111. doi: 10.1371/journal.pone.0093111. eCollection 2014.


Objective: Several studies have demonstrated the effects of health behaviours on risk of chronic diseases and mortality, but none have investigated their contribution to potentially preventable hospitalisation (PPH). We aimed to quantify the effects on risk of PPH of six health behaviours: smoking; alcohol consumption; physical activity; fruit and vegetables consumption; sitting time; and sleeping time.

Design/setting: Prospective observational study in New South Wales, Australia.

Subjects: 267,006 men and women aged 45 years and over.

Outcome measures: PPH admissions and mortality during follow-up according to individual positive health behaviours (non-smoking, <14 alcoholic drinks per week, ≥ 2.5 hours of physical activity per week, ≥ 2 servings of fruit and 5 servings of vegetables per day, <8 hours sitting and ≥ 7 hours sleeping per day) and the total number of these behaviours.

Results: During an average of 3 years follow-up, 20971 (8%) participants had at least one PPH admission. After adjusting for potential confounders, participants who reported all six positive health behaviours at baseline had 46% lower risk of PPH admission (95% CI 0.48-0.61), compared to those who reported having only one of these behaviours. Based on these risk estimates, approximately 29% of PPH admissions in Australians aged 45 years and over were attributable to not adhering to the six health behaviours. Estimates were similar for acute, chronic and vaccine-preventable categories of PPH admissions.

Conclusions: Individual and combined positive health behaviours were associated with lower risk of PPH admission. These findings suggest that there is a significant opportunity to reduce PPH by promoting healthy behaviours.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Australia
  • Female
  • Health Behavior*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Prospective Studies
  • Risk Factors
  • Vaccination / statistics & numerical data

Grant support

The study was funded by a National Health and Medical Research Council Partnership Project Grant (#1036858) and by partner agencies the Australian Commission on Safety and Quality in Health Care, the Agency for Clinical Innovation and the NSW Bureau of Health Information. The funders play no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.