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Determinants of aggregate length of hospital stay in the last year of life in Switzerland
BACKGROUND: In contrast to individual preferences, most people in developed countries die in health care institutions, with a considerable impact on health care resource use and costs. However, evidence about determinants of aggregate length of hospital stay in the last year preceding death is scant...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009660/ https://www.ncbi.nlm.nih.gov/pubmed/27586660 http://dx.doi.org/10.1186/s12913-016-1725-7 |
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author | Hedinger, Damian Braun, Julia Kaplan, Vladimir Bopp, Matthias |
author_facet | Hedinger, Damian Braun, Julia Kaplan, Vladimir Bopp, Matthias |
author_sort | Hedinger, Damian |
collection | PubMed |
description | BACKGROUND: In contrast to individual preferences, most people in developed countries die in health care institutions, with a considerable impact on health care resource use and costs. However, evidence about determinants of aggregate length of hospital stay in the last year preceding death is scant. METHODS: Nationwide individual patient data from Swiss hospital discharge statistics were linked with census and mortality records from the Swiss National Cohort. We explored determinants of aggregate length of hospital stay in the last year of life in N = 35,598 inpatients ≥65 years who deceased in 2007 or 2008. RESULTS: The average aggregate length of hospital stay in the last year of life was substantially longer in the German speaking region compared to the French (IRR 1.36 [95 % CI 1.32–1.40]) and Italian (IRR 1.22 [95 % CI 1.16–1.29]) speaking region of the country. Increasing age, female sex, multimorbidity, being divorced, foreign nationality, and high educational level prolonged, whereas home ownership shortened the aggregate length of hospital stay. Individuals with complementary private health insurance plans had longer stays than those with compulsory health insurance plans (IRR 1.04 [95 % CI 1.01–1.07]). CONCLUSIONS: The aggregate length of hospital stay during the last year of life was substantially determined by regional and socio-demographic characteristics, and only partially explained by differential health conditions. Therefore, more detailed studies need to evaluate, whether these differences are based on patients’ health care needs and preferences, or whether they are supply-driven. |
format | Online Article Text |
id | pubmed-5009660 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-50096602016-09-03 Determinants of aggregate length of hospital stay in the last year of life in Switzerland Hedinger, Damian Braun, Julia Kaplan, Vladimir Bopp, Matthias BMC Health Serv Res Research Article BACKGROUND: In contrast to individual preferences, most people in developed countries die in health care institutions, with a considerable impact on health care resource use and costs. However, evidence about determinants of aggregate length of hospital stay in the last year preceding death is scant. METHODS: Nationwide individual patient data from Swiss hospital discharge statistics were linked with census and mortality records from the Swiss National Cohort. We explored determinants of aggregate length of hospital stay in the last year of life in N = 35,598 inpatients ≥65 years who deceased in 2007 or 2008. RESULTS: The average aggregate length of hospital stay in the last year of life was substantially longer in the German speaking region compared to the French (IRR 1.36 [95 % CI 1.32–1.40]) and Italian (IRR 1.22 [95 % CI 1.16–1.29]) speaking region of the country. Increasing age, female sex, multimorbidity, being divorced, foreign nationality, and high educational level prolonged, whereas home ownership shortened the aggregate length of hospital stay. Individuals with complementary private health insurance plans had longer stays than those with compulsory health insurance plans (IRR 1.04 [95 % CI 1.01–1.07]). CONCLUSIONS: The aggregate length of hospital stay during the last year of life was substantially determined by regional and socio-demographic characteristics, and only partially explained by differential health conditions. Therefore, more detailed studies need to evaluate, whether these differences are based on patients’ health care needs and preferences, or whether they are supply-driven. BioMed Central 2016-09-01 /pmc/articles/PMC5009660/ /pubmed/27586660 http://dx.doi.org/10.1186/s12913-016-1725-7 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Hedinger, Damian Braun, Julia Kaplan, Vladimir Bopp, Matthias Determinants of aggregate length of hospital stay in the last year of life in Switzerland |
title | Determinants of aggregate length of hospital stay in the last year of life in Switzerland |
title_full | Determinants of aggregate length of hospital stay in the last year of life in Switzerland |
title_fullStr | Determinants of aggregate length of hospital stay in the last year of life in Switzerland |
title_full_unstemmed | Determinants of aggregate length of hospital stay in the last year of life in Switzerland |
title_short | Determinants of aggregate length of hospital stay in the last year of life in Switzerland |
title_sort | determinants of aggregate length of hospital stay in the last year of life in switzerland |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009660/ https://www.ncbi.nlm.nih.gov/pubmed/27586660 http://dx.doi.org/10.1186/s12913-016-1725-7 |
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