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Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China
OBJECTIVE: The purpose of this paper is to investigate the characteristics and determinants of inappropriate admission to hospital of elderly people in rural China. DESIGN: A cross-sectional study of a comparison between the elderly and non-elderly groups of people. SETTING: The survey was conducted...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502026/ https://www.ncbi.nlm.nih.gov/pubmed/31048441 http://dx.doi.org/10.1136/bmjopen-2018-026443 |
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author | Hu, Xiaomei Gao, Hongxia Zhang, Yan Li, Haomiao Su, Dai Chang, Jingjing Jiang, Di Lei, Shihan Chen, Yingchun |
author_facet | Hu, Xiaomei Gao, Hongxia Zhang, Yan Li, Haomiao Su, Dai Chang, Jingjing Jiang, Di Lei, Shihan Chen, Yingchun |
author_sort | Hu, Xiaomei |
collection | PubMed |
description | OBJECTIVE: The purpose of this paper is to investigate the characteristics and determinants of inappropriate admission to hospital of elderly people in rural China. DESIGN: A cross-sectional study of a comparison between the elderly and non-elderly groups of people. SETTING: The survey was conducted on the largest county-level general hospitals in four counties in central and western China. PARTICIPANTS: A total of 652 rural patients admitted in hospitals were surveyed, who were divided into two groups according to age: elderly group (n=230, age ≥60 years) and non-elderly group (n=422, age <60 years). PRIMARY MEASURES: The Chinese version of the appropriateness evaluation protocol was used to evaluate the inappropriate admission rates. The interactive regression models based on the relationship of age (elderly and non-elderly) with other factors and binary logistic regression models were used in the analysis of the specific factors and determinants of the inappropriate admission of elderly people. RESULT: The inappropriate admission rate for the rural elderly was 30%, which was lower than that of the non-elderly people (40.8%). Compared with the non-elderly group, women in the elderly group (OR=0.33, 95% CI 0.15 to 0.73) had a lower incidence of inappropriate admission, and elderly people with chronic diseases (OR=3.33, 95% CI 1.23 to 9.04) were more prone to being inappropriately admitted than non-elderly people with chronic diseases. The binary logistic regression analysis shows that county, age (OR=0.94. 95% CI 0.90 to 0.99), gender (OR=0.49, 95% CI 0.25 to 2.98), department and response to doctor’s admission request were the determinants of the inappropriate admission of elderly patients. CONCLUSION: The inappropriate admission rate of elderly people in rural China was high. We found that gender and chronic disease are the specific factors that were specific to non-elderly people. County, age, gender, department and response to a doctor’s admission request had substantial influence on the inappropriate admission of the elderly in rural China. |
format | Online Article Text |
id | pubmed-6502026 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65020262019-05-21 Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China Hu, Xiaomei Gao, Hongxia Zhang, Yan Li, Haomiao Su, Dai Chang, Jingjing Jiang, Di Lei, Shihan Chen, Yingchun BMJ Open Health Policy OBJECTIVE: The purpose of this paper is to investigate the characteristics and determinants of inappropriate admission to hospital of elderly people in rural China. DESIGN: A cross-sectional study of a comparison between the elderly and non-elderly groups of people. SETTING: The survey was conducted on the largest county-level general hospitals in four counties in central and western China. PARTICIPANTS: A total of 652 rural patients admitted in hospitals were surveyed, who were divided into two groups according to age: elderly group (n=230, age ≥60 years) and non-elderly group (n=422, age <60 years). PRIMARY MEASURES: The Chinese version of the appropriateness evaluation protocol was used to evaluate the inappropriate admission rates. The interactive regression models based on the relationship of age (elderly and non-elderly) with other factors and binary logistic regression models were used in the analysis of the specific factors and determinants of the inappropriate admission of elderly people. RESULT: The inappropriate admission rate for the rural elderly was 30%, which was lower than that of the non-elderly people (40.8%). Compared with the non-elderly group, women in the elderly group (OR=0.33, 95% CI 0.15 to 0.73) had a lower incidence of inappropriate admission, and elderly people with chronic diseases (OR=3.33, 95% CI 1.23 to 9.04) were more prone to being inappropriately admitted than non-elderly people with chronic diseases. The binary logistic regression analysis shows that county, age (OR=0.94. 95% CI 0.90 to 0.99), gender (OR=0.49, 95% CI 0.25 to 2.98), department and response to doctor’s admission request were the determinants of the inappropriate admission of elderly patients. CONCLUSION: The inappropriate admission rate of elderly people in rural China was high. We found that gender and chronic disease are the specific factors that were specific to non-elderly people. County, age, gender, department and response to a doctor’s admission request had substantial influence on the inappropriate admission of the elderly in rural China. BMJ Publishing Group 2019-05-01 /pmc/articles/PMC6502026/ /pubmed/31048441 http://dx.doi.org/10.1136/bmjopen-2018-026443 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Health Policy Hu, Xiaomei Gao, Hongxia Zhang, Yan Li, Haomiao Su, Dai Chang, Jingjing Jiang, Di Lei, Shihan Chen, Yingchun Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China |
title | Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China |
title_full | Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China |
title_fullStr | Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China |
title_full_unstemmed | Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China |
title_short | Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China |
title_sort | determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural china |
topic | Health Policy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502026/ https://www.ncbi.nlm.nih.gov/pubmed/31048441 http://dx.doi.org/10.1136/bmjopen-2018-026443 |
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