Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories

BACKGROUND: Population ageing puts pressure on health systems initially designed to handle acute and episodic illnesses. Segmenting an ageing population based on its healthcare utilization may enable policymakers to undertake evidence-based resource planning. We aimed to derive a typology of healthc...

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Autores principales: Roth, Leonard, Seematter-Bagnoud, Laurence, Le Pogam, Marie-Annick, Dupraz, Julien, Blanco, Juan-Manuel, Henchoz, Yves, Peytremann-Bridevaux, Isabelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793504/
https://www.ncbi.nlm.nih.gov/pubmed/36572888
http://dx.doi.org/10.1186/s12913-022-08987-z
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author Roth, Leonard
Seematter-Bagnoud, Laurence
Le Pogam, Marie-Annick
Dupraz, Julien
Blanco, Juan-Manuel
Henchoz, Yves
Peytremann-Bridevaux, Isabelle
author_facet Roth, Leonard
Seematter-Bagnoud, Laurence
Le Pogam, Marie-Annick
Dupraz, Julien
Blanco, Juan-Manuel
Henchoz, Yves
Peytremann-Bridevaux, Isabelle
author_sort Roth, Leonard
collection PubMed
description BACKGROUND: Population ageing puts pressure on health systems initially designed to handle acute and episodic illnesses. Segmenting an ageing population based on its healthcare utilization may enable policymakers to undertake evidence-based resource planning. We aimed to derive a typology of healthcare utilization trajectories in Swiss older adults. METHODS: Our work used data from the Lc65 + study, a population-based cohort of individuals aged 65 to 70 years at enrolment. The dimensions of healthcare utilization considered were ambulatory care, emergency care, hospitalizations, professional home care and nursing home stay. We applied the Sequence Analysis framework, within which we quantified the variation between each multidimensional pair of sequences, implemented a clustering procedure that grouped together older persons with similar profiles of health services use, and characterized clusters of individuals using selected baseline covariates. RESULTS: Healthcare utilization trajectories were analysed for 2271 community-dwelling older adults over a period of 11 years. Six homogeneous subgroups were identified: constant low utilization (83.3% of participants), increased utilization (4.9%), late health deterioration (4.4%), ambulatory care to nursing home (1.5%), early fatal event (3.8%) and high ambulatory care (2.1%). Associations were found between cluster membership and age, sex, household composition, self-perceived health, grip strength measurement, comorbidities, and functional dependency. CONCLUSIONS: The heterogeneous healthcare utilization profiles can be clustered into six common patterns. Different manifestations of functional decline were apparent in two distinct trajectory groups featuring regular home care use. Furthermore, a small proportion of individuals with a unique set of characteristics was related to the highest levels of ambulatory and emergency care use. New research avenues are outlined to investigate time-varying effects of health factors inside the clusters containing most unfavourable outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08987-z.
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spelling pubmed-97935042022-12-28 Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories Roth, Leonard Seematter-Bagnoud, Laurence Le Pogam, Marie-Annick Dupraz, Julien Blanco, Juan-Manuel Henchoz, Yves Peytremann-Bridevaux, Isabelle BMC Health Serv Res Research BACKGROUND: Population ageing puts pressure on health systems initially designed to handle acute and episodic illnesses. Segmenting an ageing population based on its healthcare utilization may enable policymakers to undertake evidence-based resource planning. We aimed to derive a typology of healthcare utilization trajectories in Swiss older adults. METHODS: Our work used data from the Lc65 + study, a population-based cohort of individuals aged 65 to 70 years at enrolment. The dimensions of healthcare utilization considered were ambulatory care, emergency care, hospitalizations, professional home care and nursing home stay. We applied the Sequence Analysis framework, within which we quantified the variation between each multidimensional pair of sequences, implemented a clustering procedure that grouped together older persons with similar profiles of health services use, and characterized clusters of individuals using selected baseline covariates. RESULTS: Healthcare utilization trajectories were analysed for 2271 community-dwelling older adults over a period of 11 years. Six homogeneous subgroups were identified: constant low utilization (83.3% of participants), increased utilization (4.9%), late health deterioration (4.4%), ambulatory care to nursing home (1.5%), early fatal event (3.8%) and high ambulatory care (2.1%). Associations were found between cluster membership and age, sex, household composition, self-perceived health, grip strength measurement, comorbidities, and functional dependency. CONCLUSIONS: The heterogeneous healthcare utilization profiles can be clustered into six common patterns. Different manifestations of functional decline were apparent in two distinct trajectory groups featuring regular home care use. Furthermore, a small proportion of individuals with a unique set of characteristics was related to the highest levels of ambulatory and emergency care use. New research avenues are outlined to investigate time-varying effects of health factors inside the clusters containing most unfavourable outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08987-z. BioMed Central 2022-12-26 /pmc/articles/PMC9793504/ /pubmed/36572888 http://dx.doi.org/10.1186/s12913-022-08987-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Roth, Leonard
Seematter-Bagnoud, Laurence
Le Pogam, Marie-Annick
Dupraz, Julien
Blanco, Juan-Manuel
Henchoz, Yves
Peytremann-Bridevaux, Isabelle
Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories
title Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories
title_full Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories
title_fullStr Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories
title_full_unstemmed Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories
title_short Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories
title_sort identifying common patterns of health services use: a longitudinal study of older swiss adults' care trajectories
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793504/
https://www.ncbi.nlm.nih.gov/pubmed/36572888
http://dx.doi.org/10.1186/s12913-022-08987-z
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