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Hospitalization Rates of Nursing Home Residents and Community-Dwelling Seniors in British Columbia*

Published online by Cambridge University Press:  31 March 2010

Lisa A. Ronald ,
Margaret J. McGregor ,
Kimberlyn M. McGrail ,
Robert B. Tate  and
Anne-Marie Broemling
Lisa A. Ronald*
Affiliation:
Department of Family Practice, University of British Columbia Vancouver Coastal Health Research Institute, Centre for Clinical Epidemiology and Evaluation, Family Practice Research Office, Vancouver, British Columbia
Margaret J. McGregor
Affiliation:
Department of Family Practice, University of British Columbia Vancouver Coastal Health Research Institute, Centre for Clinical Epidemiology and Evaluation, Family Practice Research Office, Vancouver, British Columbia
Kimberlyn M. McGrail
Affiliation:
Centre for Health Services and Policy Research, University of British Columbia
Robert B. Tate
Affiliation:
Department of Community Health Sciences, University of Manitoba
Anne-Marie Broemling
Affiliation:
Centre for Health Services and Policy Research, University of British Columbia
*
Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: Lisa Ronald, Centre for Clinical Epidemiology and Evaluation, Family Practice Research Office, Room 713, 828 West 10th, Vancouver, BC V5Z 1L8, (ronaldla@shaw.ca)
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Abstract

The overall use of acute care services by nursing home (NH) residents in Canada has not been well documented. Our objectives were to identify the major causes of hospitalization among NH facility residents and to compare rates to those of community-dwelling seniors. A retrospective cohort was defined using population-level health administrative data, including all individuals aged 65 years and older living in a British Columbia NH facility between April 1996 and March 1999. Hospitalization rates of NH residents were compared to estimated rates for community-dwelling seniors, using age- and sex-adjusted standardized incidence ratios (SIRs): SIR = 2.81 (95%CI: 2.71, 2.91) for femoral fractures, 1.96 (1.88, 2.04) for pneumonia, 0.73 (0.70, 0.76) for other heart disease, and 1.01 (0.99, 1.02) for all causes. NH residents have disproportionately higher rates of hospitalization for femoral fractures and pneumonia, with NH residents accounting for approximately one quarter of all femoral fracture hospitalizations of BC seniors.

Résumé

l'utilisation de l'ensemble des services de soins actifs par les pensionnaires des CHSLD (centres d'hébergement et de soins de longue durée) au Canada n'a pas été bien documentée. Nous visions à déterminer les principales causes de l'hospitalisation des pensionnaires des CHSLD et à en comparer le taux avec celui des personnes âgées résidant dans la communauté. Nous avons analysé une cohorte rétrospective à l'aide de données administratives sur la santé au niveau de la population, y compris toutes les personnes de 65 ans et plus résidant dans un CHSLD en Colombie-Britannique entre avril 1996 et mars 1999. Les taux d'hospitalisation des pensionnaires des CHSLD ont été comparés aux taux estimatifs des personnes âgées résidant dans la communauté, à l'aide de ratios standardisés d'incidence en fonction du sexe (RSI): RSI = 2,81 (95% CI: 2,71, 2,91) pour les fractures du fémur ; 1,96 (1,88, 2,04) pour la pneumonie ; 0,73 (0,70, 0,76) pour d'autres maladies du coeur; et 1,01 (0,99, 1,02) toutes causes confondues. Les pensionnaires des CHSLD sont plus susceptibles de présenter un écart plus considérable du taux d'hospitalisation pour une fracture du fémur ou une pneumonie, les pensionnaires des CHSLD représentant environ le quart des aînés de la Colombie-Britannique hospitalisés pour une fracture du fémur.

Keywords

vieillissementcentres d'hébergementcentres de soins de longue duréeaînésColombie-Britanniquefractures de la hanchetaux d'hospitalisationagingnursing homeslong-term care facilitiesseniorsBritish Columbiahospitalization rateship fractures
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 27 , Issue 1 , Spring/Printemps 2008 , pp. 109 - 115
Copyright
Copyright © Canadian Association on Gerontology 2008

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Footnotes

*

We thank Michelle Cox, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Research Institute, and Linda Ronald, who helped to edit the manuscript. This project is supported by a CIHR operating grant FY2002–2005. Dr. McGregor is supported by a Community-Based Clinical Investigator award from the Vancouver Foundation, the UBC Centre for Health Services and Policy Research, and the UBC Division of Geriatrics.

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