Evidence map›Paper›PMID 30572832›Full record

ArticleBMC geriatrics2018

Health-services utilisation amongst older persons during the last year of life: a population-based study.

Danielle Ní Chróinín, David E Goldsbury, Alexander Beveridge, Patricia M Davidson, Afaf Girgis, Nicholas Ingham, Jane L Phillips, Anne M Wilkinson, Jane M Ingham, Dianne L O'Connell

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Observational
  13. Article
  14. Observational
  15. Article
  16. Article
  17. Article
  18. Costs for Statutorily Insured Dental Services in Older Germans 2012-2017.International journal of environmental research and public health · 2021
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Danielle Ní ChróinínDepartment of Geriatric Medicine, Liverpool Hospital, UNSW, Corner of Elizabeth and Goulburn Streets, Liverpool, Sydney, NSW, 2170, Australia. dmmnic@umail.ucc.ie.ORCID 0000-0002-7711-9718
David E GoldsburyCancer Council NSW, Sydney, Australia.
Alexander BeveridgeDepartment of Geriatric Medicine, St. Vincent's Hospital, and St Vincent's Clinical School, UNSW, Sydney, Australia.
Patricia M DavidsonFaculty of Health, University of Technology Sydney, New South Wales, Australia and Johns Hopkins University, Baltimore, MD, USA.
Afaf GirgisCentre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Australia, Sydney, Australia.
Nicholas InghamDepartment of Geriatric Medicine, St. Vincent's Hospital, and UNSW Australia, St Vincent's Clinical School, Faculty of Medicine, Sydney, Australia.
Jane L PhillipsIMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Sydney, New South Wales, Australia.
Anne M WilkinsonSchool of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia.
Jane M InghamUNSW Sydney, Faculty of Medicine, St Vincent's Clinical School Darlinghurst, Sydney, Australia.
Dianne L O'ConnellCancer Council NSW, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate population-based data regarding hospital-based care utilisation by older persons during their last year of life are important in health services planning. We investigated patterns of acute hospital-based service use at the end of life, amongst older decedents in New South Wales (NSW), Australia.

methodsData from all persons aged ≥70 years who died in the state of NSW Australia in 2007 were included. Several measures of hospital-based service utilisation during the last year of life were assessed from retrospectively linked data comprising data for all registered deaths, cause of death, hospital care during the last year of life (NSW Admitted Patient Data Collection [APDC] and Emergency Department [ED] Data Collection [EDDC]), and the NSW Cancer Registry.

resultsAmongst 34,556 decedents aged ≥70 years, 82% (n = 28,366) had ≥1 hospitalisation during the last year of life (median 2), and 21% > 3 hospitalisations. Twenty-five percent (n = 5485) of decedents attended ED during the last week of life. Overall, 21% had a hospitalisation > 30 days in the last year of life, and 7% spent > 3 months in hospital; 79% had ≥1 ED attendance, 17% > 3. Nine percent (n = 3239) spent time in an intensive care unit. Fifty-three percent (n = 18,437) died in an inpatient setting. Hospital records had referenced palliative care for a fifth (7169) of decedents. Adjusting for age group, sex, place of residence, area-level socioeconomic status, and cause of death, having > 3 hospitalisations during the last year of life was more likely for persons dying from cancer (35% versus 16% non-cancer deaths, adjusted odds ratio [aOR] 2.33), 'younger' old decedents (29% for age 70-79 and 20% for age 80-89 versus 11% for 90+, aOR 2.42 and 1.77 respectively) and males (25% versus 17% females, aOR 1.38). Patterns observed for other hospital-based service use were similar.

conclusionsThis population-based study reveals high use of hospital care among older persons during their last year of life, although this decreased with increasing older age, providing important data to inform health services planning for this population, and highlighting aspects requiring further study.

Indexed as

AdultAgedAged, 80 and overAustraliaEmergency Service, HospitalFacilities and Services UtilizationFemaleHospitalizationHumansIntensive Care UnitsMaleMiddle AgedNew South WalesPalliative CarePatient Acceptance of Health CareRegistriesDeathEnd-of-lifeEnd of life careGeriatricHospital-based careLinked administrative health dataPalliative carePopulation-based

Identifiers

PMID30572832
PMCPMC6302397

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.