Does improved survival lead to a more fragile population: time trends in second and third hospital admissions among men and women above the age of 60 in Sweden

PLoS One. 2014 Jun 9;9(6):e99034. doi: 10.1371/journal.pone.0099034. eCollection 2014.

Abstract

Background: Life expectancy and time to first hospitalization have been prolonged, indicating that people live longer without needing hospital care. Life expectancy increased partially due to improved survival from severe diseases, which, however, could lead to a more fragile population. If so, time to a subsequent hospitalization could decrease. Alternatively, the overall trend of improved health could continue after the first hospitalization, prolonging also the time to subsequent hospitalizations. This study analyzes trends in subsequent hospitalizations among Swedish men and women above the age of 60, relating them to first hospitalization. It also looks at trends in the proportion of never hospitalized.

Methods: Individuals were followed in national registers for hospital admissions and deaths between 1972 and 2010. The proportion of never hospitalized individuals at given ages and time points, and the annual change in the risks of first and subsequent hospitalizations, were calculated.

Findings: An increase in the proportion of never hospitalized was seen over time. The risks of first as well as subsequent hospitalizations were reduced by almost 10% per decade for both men and women. Improvements were observed mainly for individuals below the ages of 90 and up to the year 2000.

Conclusions: The reduction in annual risk of both first and subsequent hospitalizations up to 90 years of age speaks in favor of a postponement of the overall morbidity among the elderly and provides no support for the hypothesis that the population becomes more fragile due to increased survival from severe diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Hospitalization / statistics & numerical data*
  • Hospitalization / trends
  • Humans
  • Life Expectancy
  • Male
  • Risk
  • Sweden

Grants and funding

Funding was received from the Swedish Research Council for Health, Working Life and Social Research (Forskningsrådet för hälsa, arbetsliv och välfärd, FAS) grant number: 2011-0843), and the Swedish Society of Medicine (Svenska Läkaresällskapet). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.