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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

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...

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Autores principales: Karampampa, Korinna, Andersson, Tomas, Drefahl, Sven, Ahlbom, Anders, Modig, Karin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049743/
https://www.ncbi.nlm.nih.gov/pubmed/24911650
http://dx.doi.org/10.1371/journal.pone.0099034
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author Karampampa, Korinna
Andersson, Tomas
Drefahl, Sven
Ahlbom, Anders
Modig, Karin
author_facet Karampampa, Korinna
Andersson, Tomas
Drefahl, Sven
Ahlbom, Anders
Modig, Karin
author_sort Karampampa, Korinna
collection PubMed
description 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.
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spelling pubmed-40497432014-06-18 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 Karampampa, Korinna Andersson, Tomas Drefahl, Sven Ahlbom, Anders Modig, Karin PLoS One Research Article 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. Public Library of Science 2014-06-09 /pmc/articles/PMC4049743/ /pubmed/24911650 http://dx.doi.org/10.1371/journal.pone.0099034 Text en © 2014 Karampampa et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Karampampa, Korinna
Andersson, Tomas
Drefahl, Sven
Ahlbom, Anders
Modig, Karin
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049743/
https://www.ncbi.nlm.nih.gov/pubmed/24911650
http://dx.doi.org/10.1371/journal.pone.0099034
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