Planned and Unplanned Hospital Admissions and Their Relationship with Social Factors: Findings from a National, Prospective Study of People Aged 76 Years or Older

Abstract

Objective: To examine the relationship between social factors and planned and unplanned hospital admissions among older people. Data Sources/Study Setting: 2011 data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and data from the Swedish National Patient Register until December 31, 2012. Study Design: The study had a prospective design. Data were analyzed via Cox proportional hazard regressions with variables entered as blocks (social factors, sociodemographic and ability factors, health factors). Data Collection: Data were collected via interviews with people aged 76+ (n = 931). Principal Findings: Living in institutions was negatively associated with planned admissions (hazard ratio (HR): 0.29; confidence interval (CI): 0.09–0.88), while being in receipt of home help was positively associated with unplanned admissions (HR: 1.57; CI: 1.15–2.14). Low levels of social contacts and social activity predicted unplanned admissions in bivariate analyses only. Higher ability to deal with public authorities was positively associated with planned admissions (HR: 1.77; CI: 1.13–2.78) and negatively associated with unplanned admissions, although the latter association was only significant in the bivariate analysis. Conclusions: Hospital admissions are not only due to health problems but are also influenced by the social care situation and by the ability to deal with public authorities.