Differences in healthcare use and mortality in older adults during the COVID-19 pandemic: Exploring long-term care users' vulnerability
Aguilar-Palacio, Isabel (Universidad de Zaragoza) ; Maldonado, Lina (Universidad de Zaragoza) ; Malo, Sara (Universidad de Zaragoza) ; Castel-Feced, Sara ; Cebollada, Alberto ; Aguilar-Latorre, Alejandra (Universidad de Zaragoza) ; Rabanaque, M José (Universidad de Zaragoza)
Resumen: Background
The objective of our study is to analyze the health care received by older adults with COVID-19 according to their place of residence (whether or not they live in a long-term care [LTC] facility) and to find out the effect of health care on mortality.
Methods
Retrospective cohort study based in Aragón (Spain) from March 2020 to March 2021 in patients aged 65 years or older with a confirmed COVID-19 infection. The population was classified according to their place of residence (living in a LTC or not). A propensity score was used to match individuals by sex and age. The effect of living in a LTC facility on healthcare delivery and mortality was conducted using adjusted multivariate models. Varimp was used to estimate the best predictors of mortality for both groups.
Results
Healthcare services utilization varied depending on whether the patients lived in a LTC facility or not. The time to diagnosis was shorter in institutionalized patients, but the time to hospital admission was longer. Length of hospital stays, risk of ICU admission and 30-day mortality were also different and remained statistically significant in the adjusted models. The variables that were more important in the association between healthcare utilization and mortality were those associated with greater severity of COVID-19.
Conclusions
There were differences in health care for older adults diagnosed with COVID-19 according to their place of residence. There is a need to strengthen collaboration between professionals in LTC centers and health services to provide equitable health care.
Idioma: Inglés
DOI: 10.1016/j.heliyon.2024.e34840
Año: 2024
Publicado en: Heliyon 10, 14 (2024), e34840 [9 pp.]
ISSN: 2405-8440
Financiación: info:eu-repo/grantAgreement/ES/DGA-GRISSA/B09-23R
Financiación: info:eu-repo/grantAgreement/ES/ISCIII-RICAPPS/RD21-0016-0005
Tipo y forma: Artículo (Versión definitiva)
Área (Departamento): Área Métodos Cuant.Econ.Empres (Dpto. Economía Aplicada)
Área (Departamento): Área Psicolog.Evolut.Educac (Dpto. Psicología y Sociología)
Área (Departamento): Área Medic.Prevent.Salud Públ. (Dpto. Microb.Ped.Radio.Sal.Pú.)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace.
Exportado de SIDERAL (2024-07-31-09:23:07)
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The objective of our study is to analyze the health care received by older adults with COVID-19 according to their place of residence (whether or not they live in a long-term care [LTC] facility) and to find out the effect of health care on mortality.
Methods
Retrospective cohort study based in Aragón (Spain) from March 2020 to March 2021 in patients aged 65 years or older with a confirmed COVID-19 infection. The population was classified according to their place of residence (living in a LTC or not). A propensity score was used to match individuals by sex and age. The effect of living in a LTC facility on healthcare delivery and mortality was conducted using adjusted multivariate models. Varimp was used to estimate the best predictors of mortality for both groups.
Results
Healthcare services utilization varied depending on whether the patients lived in a LTC facility or not. The time to diagnosis was shorter in institutionalized patients, but the time to hospital admission was longer. Length of hospital stays, risk of ICU admission and 30-day mortality were also different and remained statistically significant in the adjusted models. The variables that were more important in the association between healthcare utilization and mortality were those associated with greater severity of COVID-19.
Conclusions
There were differences in health care for older adults diagnosed with COVID-19 according to their place of residence. There is a need to strengthen collaboration between professionals in LTC centers and health services to provide equitable health care.
Idioma: Inglés
DOI: 10.1016/j.heliyon.2024.e34840
Año: 2024
Publicado en: Heliyon 10, 14 (2024), e34840 [9 pp.]
ISSN: 2405-8440
Financiación: info:eu-repo/grantAgreement/ES/DGA-GRISSA/B09-23R
Financiación: info:eu-repo/grantAgreement/ES/ISCIII-RICAPPS/RD21-0016-0005
Tipo y forma: Artículo (Versión definitiva)
Área (Departamento): Área Métodos Cuant.Econ.Empres (Dpto. Economía Aplicada)
Área (Departamento): Área Psicolog.Evolut.Educac (Dpto. Psicología y Sociología)
Área (Departamento): Área Medic.Prevent.Salud Públ. (Dpto. Microb.Ped.Radio.Sal.Pú.)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace. Exportado de SIDERAL (2024-07-31-09:23:07)
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Registro creado el 2024-07-31, última modificación el 2024-07-31