Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study

Abstract Acute healthcare services are extremely important, particularly during the COVID-19 pandemic, as healthcare demand has rapidly intensified, and resources have become insufficient. Studies on specific prepandemic hospitalization and emergency department visit (EDV) trends in proximity to dea...

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Autores principales:	Claudio Barbiellini Amidei, Silvia Macciò, Anna Cantarutti, Francesca Gessoni, Andrea Bardin, Loris Zanier, Cristina Canova, Lorenzo Simonato
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d28de7d7537a4aa1912f0155115a36f2
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spelling	oai:doaj.org-article:d28de7d7537a4aa1912f0155115a36f22021-11-08T10:50:26ZHospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study10.1038/s41598-021-00648-12045-2322https://doaj.org/article/d28de7d7537a4aa1912f0155115a36f22021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-00648-1https://doaj.org/toc/2045-2322Abstract Acute healthcare services are extremely important, particularly during the COVID-19 pandemic, as healthcare demand has rapidly intensified, and resources have become insufficient. Studies on specific prepandemic hospitalization and emergency department visit (EDV) trends in proximity to death are limited. We examined time-trend specificities based on sex, age, and cause of death in the last 2 years of life. Datasets containing all hospitalizations and EDVs of elderly residents in Friuli-Venezia Giulia, Italy (N = 411,812), who died between 2002 and 2014 at ≥ 65 years, have been collected. We performed subgroup change-point analysis of monthly trends in the 2 years preceding death according to sex, age at death (65–74, 75–84, 85–94, and ≥ 95 years), and main cause of death (cancer, cardiovascular, or respiratory disease). The proportion of decedents (N = 142,834) accessing acute healthcare services increased exponentially in proximity to death (hospitalizations = 4.7, EDVs = 3.9 months before death). This was inversely related to age, with changes among the youngest and eldest decedents at 6.6 and 3.5 months for hospitalizations and at 4.6 and 3.3 months for EDVs, respectively. Healthcare use among cancer patients intensified earlier in life (hospitalizations = 6.8, EDVs = 5.8 months before death). Decedents from respiratory diseases were most likely to access hospital-based services during the last month of life. No sex-based differences were found. The greater use of acute healthcare services among younger decedents and cancer patients suggests that policies potentiating primary care support targeting these at-risk groups may reduce pressure on hospital-based services.Claudio Barbiellini AmideiSilvia MacciòAnna CantaruttiFrancesca GessoniAndrea BardinLoris ZanierCristina CanovaLorenzo SimonatoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Claudio Barbiellini Amidei Silvia Macciò Anna Cantarutti Francesca Gessoni Andrea Bardin Loris Zanier Cristina Canova Lorenzo Simonato Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study
description	Abstract Acute healthcare services are extremely important, particularly during the COVID-19 pandemic, as healthcare demand has rapidly intensified, and resources have become insufficient. Studies on specific prepandemic hospitalization and emergency department visit (EDV) trends in proximity to death are limited. We examined time-trend specificities based on sex, age, and cause of death in the last 2 years of life. Datasets containing all hospitalizations and EDVs of elderly residents in Friuli-Venezia Giulia, Italy (N = 411,812), who died between 2002 and 2014 at ≥ 65 years, have been collected. We performed subgroup change-point analysis of monthly trends in the 2 years preceding death according to sex, age at death (65–74, 75–84, 85–94, and ≥ 95 years), and main cause of death (cancer, cardiovascular, or respiratory disease). The proportion of decedents (N = 142,834) accessing acute healthcare services increased exponentially in proximity to death (hospitalizations = 4.7, EDVs = 3.9 months before death). This was inversely related to age, with changes among the youngest and eldest decedents at 6.6 and 3.5 months for hospitalizations and at 4.6 and 3.3 months for EDVs, respectively. Healthcare use among cancer patients intensified earlier in life (hospitalizations = 6.8, EDVs = 5.8 months before death). Decedents from respiratory diseases were most likely to access hospital-based services during the last month of life. No sex-based differences were found. The greater use of acute healthcare services among younger decedents and cancer patients suggests that policies potentiating primary care support targeting these at-risk groups may reduce pressure on hospital-based services.
format	article
author	Claudio Barbiellini Amidei Silvia Macciò Anna Cantarutti Francesca Gessoni Andrea Bardin Loris Zanier Cristina Canova Lorenzo Simonato
author_facet	Claudio Barbiellini Amidei Silvia Macciò Anna Cantarutti Francesca Gessoni Andrea Bardin Loris Zanier Cristina Canova Lorenzo Simonato
author_sort	Claudio Barbiellini Amidei
title	Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study
title_short	Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study
title_full	Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study
title_fullStr	Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study
title_full_unstemmed	Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study
title_sort	hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d28de7d7537a4aa1912f0155115a36f2
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Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study

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