Background
A changing health and social care system
Increased ED visits and frequent ED use by older people
Methods
Study population
Data sources
Variable specification
Outcome variable
Socio-demographic variables
Health and health care utilisation variables
Statistical analysis
65–79 yrs | 80+ yrs | |||||
---|---|---|---|---|---|---|
Total | Men | Women | Men | Women | ||
N = 356,375 | n = 124,232 | n = 138.187 | n = 34,263 | n = 59,693 | ||
(%) | (%) | (%) | (%) | (%) | ||
Income | Group 1 (low) | 19.8 | 13.6 | 18.7 | 16.0 | 37.2 |
Group 2 | 20.0 | 13.7 | 18.5 | 29.5 | 30.9 | |
Group 3 | 19.9 | 19.1 | 19.7 | 28.1 | 17.7 | |
Group 4 | 19.9 | 24.8 | 21.7 | 15.5 | 8.2 | |
Group 5 (high) | 20.0 | 28.3 | 20.9 | 10.6 | 5.8 | |
Missing | 0.4 | 0.5 | 0.4 | 0.3 | 0.2 | |
Residential area | Rest | 96.6 | 96.4 | 96.3 | 97.1 | 97.1 |
Disadvantaged | 3.4 | 3.6 | 3.7 | 2.9 | 2.9 | |
Country of birth | Sweden | 79.7 | 79.7 | 78.9 | 82.8 | 79.9 |
Other | 19.6 | 19.8 | 20.8 | 15.7 | 18.5 | |
Missing | 0.72 | 0.5 | 0.3 | 1.5 | 1.6 | |
Living situation | Cohabiting | 47.9 | 62.1 | 47.2 | 51.2 | 17.9 |
Alone | 47.8 | 36.8 | 51.6 | 39.3 | 66.6 | |
Institution | 4.4 | 1.1 | 1.2 | 9.5 | 15.5 | |
Multi-morbidity | None | 19.6 | 25.3 | 20.8 | 10.1 | 10.6 |
1 condition | 19.0 | 21.1 | 21.4 | 12.4 | 12.7 | |
2 to 4 conditions | 41.5 | 38.9 | 42.8 | 42.4 | 43.6 | |
≥5 conditions | 19.9 | 14.7 | 15.0 | 35.1 | 33.1 | |
Home-health care | None | 92.9 | 97 | 96.9 | 84.2 | 80.4 |
Basic care | 6.0 | 2.0 | 2.3 | 13.6 | 18.3 | |
Advanced care | 1.1 | 1.0 | 0.8 | 2.2 | 1.3 | |
Oupatient visits | 0–5 visits | 37.1 | 44.8 | 38.6 | 23.7 | 25.0 |
6–10 visits | 18.5 | 18.7 | 18.5 | 16.5 | 16.2 | |
> 10 visits | 44.4 | 36.5 | 41.6 | 59.8 | 58.8 | |
ED visits | None | 74.9 | 79.4 | 80.3 | 60.2 | 61.2 |
1 visit | 14.7 | 12.6 | 12.4 | 20.2 | 21.1 | |
2–3 visits | 7.9 | 6.1 | 5.6 | 14.3 | 13.5 | |
4+ visits | 2.5 | 1.9 | 1.6 | 5.3 | 4.2 | |
Died in 2014 | Died | 3.8 | 2.0 | 1.3 | 10.2 | 9.4 |
65–79 yrs | 80+ yrs | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Totsl | Men | Women | Men | Women | |||||||
N = 356,375 | n = 124,232 | n = 138,187 | n = 34,263 | n = 59,693 | |||||||
ED rate | FED% | ED rate | FED% | ED rate | FED% | ED rate | FED% | ED rate | FED% | ||
Total = | 0.56 | 2.5 | 0.43 | 1.9 | 0.37 | 1.6 | 1.12 | 5.3 | 0.95 | 4.2% | |
Income | Group 1 low | 0.77 | 3.6 | 0.65 | 3.4 | 0.54 | 3.6 | 1.32 | 6.4 | 1.00 | 4.4 |
Group 2 | 0.74 | 3.4 | 0.60 | 2.9 | 0.48 | 2.3 | 1.16 | 6.3 | 0.99 | 4.4 | |
Group 3 | 0.55 | 2.5 | 0.44 | 2.0 | 0.35 | 1.4 | 1.08 | 5.2 | 0.86 | 4.1 | |
Group 4 | 0.39 | 1.6 | 0.35 | 1.4 | 0.27 | 1.0 | 0.97 | 5.0 | 0.81 | 3.7 | |
Group 5 high | 0.35 | 1.3 | 0.30 | 1.1 | 0.26 | 1.9 | 1.01 | 4.6 | 0.87 | 2.7 | |
Residential area | Rest | 0.56 | 2.5 | 0.42 | 1.9 | 0.37 | 1.6 | 1.13 | 5.4 | 0.95 | 4.1 |
Disadvantaged | 0.55 | 3.2 | 0.51 | 3.0 | 0.46 | 2.3 | 0.73 | 3.6 | 0.85 | 5.9 | |
Country of birth | Sweden | 0.56 | 2.5 | 0.41 | 1.9 | 0.37 | 1.5 | 1.13 | 5.4 | 0.95 | 4.1 |
Other | 0.45 | 2.4 | 0.38 | 2.0 | 0.36 | 1.6 | 0.71 | 4.3 | 0.70 | 4.2 | |
Living situation | Cohabiting | 0.44 | 1.9 | 0.37 | 1.6 | 0.30 | 1.2 | 1.03 | 4.9 | 0.83 | 3.7 |
Alone | 0.63 | 3.0 | 0.49 | 2.4 | 0.42 | 1.9 | 1.18 | 5.8 | 0.98 | 4.5 | |
Institution | 1.04 | 4.2 | 1.24 | 6.4 | 0.96 | 5.1 | 1.32 | 5.2 | 0.93 | 3.2 | |
Multi-morbidity | None | 0.20 | 0.5 | 0.17 | 0.4 | 0.15 | 0.4 | 0.48 | 1.5 | 0.45 | 1.0 |
1 condition | 0.29 | 0.8 | 0.24 | 0.8 | 0.21 | 0.6 | 0.59 | 2.0 | 0.59 | 1.3 | |
2–4 conditions | 0.49 | 1.9 | 0.41 | 1.7 | 0.36 | 1.3 | 0.85 | 3.5 | 0.75 | 2.8 | |
≥5 conditions | 1.31 | 7.4 | 1.16 | 6.7 | 0.96 | 5.7 | 1.82 | 9.8 | 1.50 | 8.2 | |
Home-health care | None | 0.44 | 1.7 | 0.37 | 1.5 | 0.32 | 1.2 | 0.86 | 3.4 | 0.73 | 2.4 |
Basic care | 1.98 | 12.7 | 2.03 | 16.2 | 1.81 | 12.2 | 2.40 | 14.7 | 1.84 | 11.1 | |
Advanced care | 3.16 | 18.8 | 3.26 | 19.1 | 2.88 | 18.7 | 3.64 | 21.3 | 2.95 | 16.1 | |
Outpatient care | 0–5 visits | 0.23 | 0.2 | 0.14 | 0.1 | 0.10 | 0.1 | 0.88 | 0.4 | 0.66 | 0.4 |
6–10 visits | 0.34 | 0.7 | 0.28 | 0.6 | 0.22 | 0.3 | 0.72 | 1.4 | 0.60 | 1.3 | |
> 10 visits | 0.93 | 5.2 | 0.85 | 4.1 | 0.70 | 3.6 | 1.33 | 8.3 | 1.17 | 6.7 | |
Died in 2014 | Survived | 0.43 | 2.2 | 0.35 | 1.7 | 0.33 | 1.4 | 0.74 | 4.7 | 0.70 | 3.9 |
Died | 3.79 | 9.6 | 4.02 | 11.8 | 3.68 | 11.9 | 4.41 | 11.0 | 3.33 | 7.1 |
Model 0 | Model 1 | Model 2 | |
---|---|---|---|
OR (95% CI) | OR (95% CI) | OR (95% CI) | |
(a) | |||
Men (65–79 yrs) | |||
Income group 1 low | 3.13 (2.75–3.56) | 2.09 (1.80–2.42) | 1.75 (1.51–2.03) |
Income group 2 | 2.67 (2.34–3.05) | 1.53 (1.32–1.76) | 1.37 (1.14–1.58) |
Income group 3 | 1.77 (1.54–2.02) | 1.19 (1.03–1.36) | 1.11 (0.97–1.28) |
Income group 4 | 1.26 (1.10–1.45) | 1.07 (0.93–1.23) | 1.00 (0.87–1.15) |
Income group 5 high | 1.00 | 1.00 | 1.00 |
Age in years | 1.04 (1.03–1.05) | 1.01 (1.00–1.02) | |
Living alone | 1.30 (1.18–1.42) | 1.18 (1.07–1.30) | |
Institutional care | 1.72 (1.36–2.18) | 3.46 (2.72–4.41) | |
Disadvantaged area | 1.25 (1.04–1.51) | 1.26 (1.04–1.52) | |
Born outside Sweden | 0.91 (0.82–1.02) | 1.00 (0.89–1.11) | |
Multi-morbidity | 1.37 (1.35–1.39) | 1.19 (1.17–1.20) | |
Basic care | 3.35 (2.96–3.81) | ||
Advanced care | 5.22 (4.44–6.12) | ||
6–10 outpatient visits | 4.73 (3.46–6.47) | ||
>10 outpatient visits | 24.61 (18.77–32.26) | ||
Women (65–79 yrs) | |||
Income group 1 low | 2.91 (2.52–3.36) | 1.74 (1.48–2.06) | 1.51 (1.28–1.79) |
Income group 2 | 2.62 (2.27–3.04) | 1.54 (1.31–1.80) | 1.39 (1.18–1.63) |
Income group 3 | 1.55 (1.32–1.82) | 1.11 (0.94–1.31) | 1.05 (0.89–1.23) |
Income group 4 | 1.08 (0.91–1.28) | 0.96 (0.81–1.13) | 0.91 (0.76–1.07) |
Income group 5 high | 1.00 | 1.00 | 1.00 |
Age in years | 1.03 (1.02–1.04) | 0.91 (0.76–1.07) | |
Living alone | 1.07 (0.97–1.19) | 0.99 (0.89–1.10) | |
Institutional care | 1.53 (1.19–1.97) | 3.26 (2.52–4.21) | |
Disadvantaged area | 1.13 (0.93–1.38) | 1.09 (0.89–1.34) | |
Born outside Sweden | 0.89 (0.80–0.99) | 0.93 (0.84–1.04) | |
Multi-morbidity | 1.40 (1.38–1.41) | 1.23 (1.21–1.24) | |
Basic care | 3.18 (2.79–3.62) | ||
Advanced care | 6.82 (5.77–8.06) | ||
6–10 outpatient visits | 2.62 (1.84–3.74) | ||
>10 outpatient visits | 18.05 (13.92–24.78) | ||
(b) | |||
Men (80+ yrs) | |||
Income group 1 low | 1.42 (1.17–1.72) | 1.58 (1.29–1.92) | 1.54 (1.26–1.89) |
Income group 2 | 1.17 (0.97–1.39) | 1.15 (0.96–1.38) | 1.11 (0.92–1.34) |
Income group 3 | 1.16 (0.97–1.39) | 1.19 (0.99–1.43) | 1.14 (0.95–1.36) |
Income group 4 | 1.09 (0.90–1.33) | 1.12 (0.92–1.38) | 1.10 (0.90–1.36) |
Income group 5 high | 1.00 | 1.00 | 1.00 |
Age in years | 1.03 (1.02–1.05) | 1.01 (1.00–1.03) | |
Living alone | 1.11 (1.00–1.23) | 1.00 (0.90–1.11) | |
Institutional care | 0.80 (0.67–0.96) | 2.12 (1.75–2.56) | |
Disadvantaged area | 0.70 (0.49–1.00) | 0.69 0.49–1.00) | |
Born outside Sweden | 0.89 (0.77–1.02) | 0.95 (0.82–1.09) | |
Multi-morbidity | 1.25 (1.24–1.27) | 1.15 (1.13–1.17) | |
Basic care | 2.60 (2.32–2.93) | ||
Advanced care | 4.00 (3.29–4.86) | ||
6–10 outpatient visits | 3.35 (2.23–5.04) | ||
>10 outpatient visits | 14.14 (9.94–20.11) | ||
Women (80+ yrs) | |||
Income group 1 low | 1.66 (1.34–2.06) | 1.56 (1.25–1.95) | 1.50 (1.19–1.87) |
Income group 2 | 1.67 (1.35–2.08) | 1.56 (1.24–1.94) | 1.47 (1.18–1.85) |
Income group 3 | 1.52 (1.21–1.91) | 1.49 (1.18–1.88) | 1.40 (1.11–1.77) |
Income group 4 | 1.39 (1.08–1.79) | 1.43 (1.10–1.85) | 1.37 (1.05–1.78) |
Income group 5 high | 1.00 | 1.00 | 1.00 |
Age in years | 1.04 (1.03–1.05) | 1.02 (1.01–1.03) | |
Living alone | 1.04 (0.92–1.18) | 0.94 (0.83–1.07) | |
Institutional care | 0.66 (0.56–0.78) | 1.82 (1.53–2.18) | |
Disadvantaged area | 1.43 (1.15–1.77) | 1.39 (1.12–1.73) | |
Born outside Sweden | 1.08 (0.97–1.20) | 1.13 (1.01–1.25) | |
Multi-morbidity | 1.31 (1.29–1.33) | 1.21 (1.20–1.23) | |
Basic care | 2.46 (2.23–2.71) | ||
Advanced care | 3.56 (2.88–4.39) | ||
6–10 outpatient visits | 3.28 (2.37–4.55) | ||
>10 outpatient visits | 11.68 (8.82–15.48) |