Hospitalization Trajectories in Home- and Community-Based Services Recipients: The Influence of Physician and Social Care Density

Min Hee Kim, Xiaoling Xiang and Jessica Kelley

The Journals of Gerontology: Series B, 2021, vol. 76, issue 8, 1679-1690

Abstract: ObjectivesRepeated hospitalizations among older adults receiving Home- and Community-Based Services (HCBS) may indicate unmet medical and social needs. This study examined all-cause hospitalization trajectories and the association between area-level resource density for medical and social care and the trajectory group membership.MethodsThe study participants included 11,223 adults aged 60 years or older who were enrolled in public HCBS programs in Michigan between 2008 and 2012. Data sources included the Michigan interRAI-Home Care, Dartmouth Atlas of Health Care Data, the American Community Survey, and the County Business Patterns from the Census Bureau. The group-based trajectory modeling was used to identify trajectories of hospitalization over 15 months. Correlates of the trajectories were examined using multinomial logistic regression.ResultsFour distinct hospitalization trajectory groups emerged: “never” (43.1%)—individuals who were rarely hospitalized during the study period, “increasing” (19.9%)—individuals who experienced an increased risk of hospitalization, “decreasing” (21.6%)—individuals with a decreased risk, and “frequent” (15.8%)—individuals with frequent hospitalizations. Older adults living in areas with a higher number of social service organizations for older adults and persons with disability were less likely to be on the “frequent” trajectory relative to the “decreasing” trajectory. The density of primary care physicians was not associated with the trajectory group membership.DiscussionArea-level social care resource density contributes to changes in 15-month hospitalization risks among older adult recipients of HCBS.

Keywords: Home- and Community-Based Services; Hospitalization trajectory; interRAI-HC; Primary care physician density; Social care density (search for similar items in EconPapers)
Date: 2021
References: Add references at CitEc
Citations:

Downloads: (external link)
http://hdl.handle.net/10.1093/geronb/gbaa199 (application/pdf)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:oup:geronb:v:76:y:2021:i:8:p:1679-1690.

Ordering information: This journal article can be ordered from
https://academic.oup.com/journals

Access Statistics for this article

The Journals of Gerontology: Series B is currently edited by Psychological Sciences - S. Duke Han, PhD and Social Sciences - Jessica A Kelley, PhD, FGSA

More articles in The Journals of Gerontology: Series B from The Gerontological Society of America Oxford University Press, Great Clarendon Street, Oxford OX2 6DP, UK.
Bibliographic data for series maintained by Oxford University Press ().