J Korean Gerontol Nurs.
2022 May;24(2):162-173. 10.17079/jkgn.2022.24.2.162.
Factors Associated with Acute Hospitalizations and Mortality of Older Adults in Long-Term Care Facilities and Long-Term Care Hospitals: A Population-Based, Pubic-Insurance Big-Data Analysis
- Affiliations
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- 1Researcher, Institute of Health and Environment, Seoul National University, Seoul, Korea
- 2Assistant Professor, Division of Social Welfare and Health Administration, Wonkwang University, Iksan, Korea
- 3Assistant Professor, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 4Professor, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 5Professor, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University; Institute of Health and Environment, Seoul National University; Institute on Aging, Seoul National University, Seoul National University, Seoul,
- KMID: 2540593
- DOI: http://doi.org/10.17079/jkgn.2022.24.2.162
Abstract
- Purpose
This study examined individual, institutional, and regional factors associated with 90-day acute hospitalizations and 1-year mortality among older people admitted to long-term care facilities (LTCFs) and long-term care hospitals (LTCH) in Korea.
Methods
We analyzed the National Health Insurance Services (NHIS) Elderly Cohort Database linked with regional statistics. The sample included 13,839 LTCF residents and 23,962 LTCH patients. Multi-level logistic regression analyses were conducted.
Results
The risk for 90-day acute hospital admission was positively associated with being male and having comorbidities among both LTCF residents and LTCH patients. Being 80+ years old and having a severe case-mix (LTCF grade 1/LTCH groups A1 & 2) were positively associated with acute hospitalizations among LTCF residents, but the relationships were negative among LTCH patients. People in urban LTCFs and/or those in facilities located in regions with a higher physician supply had lower acute hospitalizations. The risk for 1-year mortality after LTCF or LTCH admission was positively associated with being an old male, having a severe case-mix, and comorbidities. Among institutional factors, public ownership for LTCFs and being a larger size for LTCHs were negatively associated with mortality.
Conclusion
This health and long-term care big data analysis showed various factors influenced adverse health outcomes among older Koreans receiving institutionalized long-term care, and the patterns of the relationships were different for LTCFs and LTCHs. Further investigations are needed into the mechanisms underlying the complex dynamics among the multi-level determinants of acute care utilization and mortality by institution type.
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