Factors associated with institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic: a 3-year follow-up study

Eur Geriatr Med. 2020 Oct;11(5):745-751. doi: 10.1007/s41999-020-00338-7. Epub 2020 Jun 4.

Abstract

Purpose: To examine the effect of predictive factors on institutionalization among older patients.

Methods: The participants were older (aged 75 years or older) home-dwelling citizens evaluated at Urgent Geriatric Outpatient Clinic (UrGeriC) for the first time between the 1st of September 2013 and the 1st of September 2014 (n = 1300). They were followed up for institutionalization for 3 years. Death was used as a competing risk in Cox regression analyses.

Results: The mean age of the participants was 85.1 years (standard deviation [SD] 5.5, range 75-103 years), and 74% were female. The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The mean age for institutionalization was 86.1 (SD 5.6) years. According to multivariate Cox regression analyses, the use of home care (hazard ratio 2.43, 95% confidence interval 1.80-3.27, p < 0.001), dementia (2.38, 1.90-2.99, p < 0.001), higher age (≥ 95 vs. 75-84; 1.65, 1.03-2.62, p = 0.036), and falls during the previous 12 months (≥ 2 vs. no falls; 1.54, 1.10-2.16, p = 0.012) significantly predicted institutionalization during the 3-year follow-up.

Conclusion: Cognitive and/or functional impairment mainly predicted institutionalization among older patients of UrGeriC having health problems and acute difficulties in managing at home.

Keywords: Institutionalization; Older people; Predictor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities
  • Female
  • Follow-Up Studies
  • Home Care Services*
  • Humans
  • Institutionalization*
  • Male