Acute healthcare resource utilization by age: A cohort study.

<h4>Background</h4>Granular data related to the likelihood of individuals of different ages accessing acute and critical care services over time is lacking.<h4>Methods</h4>We used population-based, administrative data from Ontario to identify residents of specific ages (20, 3...

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Autores principales:	Bourke W Tillmann, Longdi Fu, Andrea D Hill, Damon C Scales, Robert A Fowler, Brian H Cuthbertson, Hannah Wunsch
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/26a9355027f846bea770d9cd6d98eab3
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spelling	oai:doaj.org-article:26a9355027f846bea770d9cd6d98eab32021-12-02T20:11:18ZAcute healthcare resource utilization by age: A cohort study.1932-620310.1371/journal.pone.0251877https://doaj.org/article/26a9355027f846bea770d9cd6d98eab32021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251877https://doaj.org/toc/1932-6203<h4>Background</h4>Granular data related to the likelihood of individuals of different ages accessing acute and critical care services over time is lacking.<h4>Methods</h4>We used population-based, administrative data from Ontario to identify residents of specific ages (20, 30, 40, etc. to 100) on January 1st every year from 1995-2019. We assessed rates of emergency department (ED) visits (2003-19), hospitalizations, intensive care unit (ICU) admissions (2003-19), and mechanical ventilation.<h4>Findings</h4>Overall the 25-year study period, ED were the most common acute healthcare encounter with 100-year-olds having the lowest rate (138.7/1,000) and 90-year-olds the highest (378.5/1,000). Rates of hospitalization ranged from 24.2/1,000 for those age 20 up to 224.9/1,000 for those age 90. Rates of ICU admission and mechanical ventilation were lowest for those age 20 (1.0 and 0.4/1,000), more than tripled by age 50 (3.3 and 1.7/1,000) and peaked at age 80 (20.3 and 10.1/1,000). Over time rates of ED visits increased (164.3 /1,000 in 2003 vs 199.1 /1,000 in 2019) as did rates of invasive mechanical ventilation (2.0/1,000 in 1995 vs 2.9/1,000 in 2019), whereas rates of ICU admission remained stable (4.8/1,000 in 2003 vs 4.9/1,000 in 2019) and hospitalization declined (66.8/1,000 in 1995 vs 51.5/1,000 in 2019). Age stratified analysis demonstrated that rates of ED presentation increased for those age 70 and younger while hospitalization decreased for all age groups; ICU admission and mechanical ventilation rates changed variably by age, with increasing rates demonstrated primarily among people under the age of 50.<h4>Interpretation</h4>Rates of hospitalizations have decreased over time across all age groups, whereas rates of ED presentation, ICU admissions, and mechanical ventilation have increased, primarily driven by younger adults. These findings suggest that although the delivery of healthcare may be moving away from inpatient medicine, there is a growing population of young adults requiring significant healthcare resources.Bourke W TillmannLongdi FuAndrea D HillDamon C ScalesRobert A FowlerBrian H CuthbertsonHannah WunschPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251877 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bourke W Tillmann Longdi Fu Andrea D Hill Damon C Scales Robert A Fowler Brian H Cuthbertson Hannah Wunsch Acute healthcare resource utilization by age: A cohort study.
description	<h4>Background</h4>Granular data related to the likelihood of individuals of different ages accessing acute and critical care services over time is lacking.<h4>Methods</h4>We used population-based, administrative data from Ontario to identify residents of specific ages (20, 30, 40, etc. to 100) on January 1st every year from 1995-2019. We assessed rates of emergency department (ED) visits (2003-19), hospitalizations, intensive care unit (ICU) admissions (2003-19), and mechanical ventilation.<h4>Findings</h4>Overall the 25-year study period, ED were the most common acute healthcare encounter with 100-year-olds having the lowest rate (138.7/1,000) and 90-year-olds the highest (378.5/1,000). Rates of hospitalization ranged from 24.2/1,000 for those age 20 up to 224.9/1,000 for those age 90. Rates of ICU admission and mechanical ventilation were lowest for those age 20 (1.0 and 0.4/1,000), more than tripled by age 50 (3.3 and 1.7/1,000) and peaked at age 80 (20.3 and 10.1/1,000). Over time rates of ED visits increased (164.3 /1,000 in 2003 vs 199.1 /1,000 in 2019) as did rates of invasive mechanical ventilation (2.0/1,000 in 1995 vs 2.9/1,000 in 2019), whereas rates of ICU admission remained stable (4.8/1,000 in 2003 vs 4.9/1,000 in 2019) and hospitalization declined (66.8/1,000 in 1995 vs 51.5/1,000 in 2019). Age stratified analysis demonstrated that rates of ED presentation increased for those age 70 and younger while hospitalization decreased for all age groups; ICU admission and mechanical ventilation rates changed variably by age, with increasing rates demonstrated primarily among people under the age of 50.<h4>Interpretation</h4>Rates of hospitalizations have decreased over time across all age groups, whereas rates of ED presentation, ICU admissions, and mechanical ventilation have increased, primarily driven by younger adults. These findings suggest that although the delivery of healthcare may be moving away from inpatient medicine, there is a growing population of young adults requiring significant healthcare resources.
format	article
author	Bourke W Tillmann Longdi Fu Andrea D Hill Damon C Scales Robert A Fowler Brian H Cuthbertson Hannah Wunsch
author_facet	Bourke W Tillmann Longdi Fu Andrea D Hill Damon C Scales Robert A Fowler Brian H Cuthbertson Hannah Wunsch
author_sort	Bourke W Tillmann
title	Acute healthcare resource utilization by age: A cohort study.
title_short	Acute healthcare resource utilization by age: A cohort study.
title_full	Acute healthcare resource utilization by age: A cohort study.
title_fullStr	Acute healthcare resource utilization by age: A cohort study.
title_full_unstemmed	Acute healthcare resource utilization by age: A cohort study.
title_sort	acute healthcare resource utilization by age: a cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/26a9355027f846bea770d9cd6d98eab3
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Acute healthcare resource utilization by age: A cohort study.

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