[Mortality and use of healthcare resources in elderly patients in Seville: Differences between institutionalised patients and those included in a home care program]

Abstract

Objectives: Society is ageing, and as a consequence, the population with increased frailty and comorbidity is growing. The aim is to analyse the mortality and its potential factors, as well as the use of healthcare resources in elderly patients, and to study the differences between institutionalised patients and those included in a home care program.

Materials and methods: An observational, longitudinal and prospective cohort study was conducted in Seville during 2016. The study subjects consisted of 1314 elderly patients (1061 institutionalised and 253 at home). The variables studied included mortality and its potential factors, and the use of healthcare resources.

Results: No differences were found in mortality between institutionalised and home care program patients (RR=1.044; 95% CI; 0.74-1.46; P=.799). The leading cause of death was circulatory diseases followed by respiratory diseases. Among the factors explaining the mortality, it is important to highlight: age, dependency and admissions in the hospital or the emergency department. The patient's functional independence is associated with a higher survival rate. Differences were found between both groups in the number of calls to the Critical Care and Emergency Services (P=.022) or the primary care doctor (P<.001) and in the hospital admissions (P<.001), the first 2differences being higher in home care program patients, and the latter in institutionalised patients.

Conclusions: There are no differences between groups either in the mortality or in the cause of death. Age, functional dependency and admissions in the hospital are factors which explain the mortality. The use of healthcare resources is higher in patients at home.

Keywords: Aged; Anciano; Atención domiciliaria; Home nursing; Institucionalización; Institutionalisation; Mortalidad; Mortality.