Evidence map›Paper›PMID 38847363›Full record

ArticleJournal of the American Geriatrics Society2024

Geriatric conditions and healthcare utilization among older adults living in subsidized housing.

Sarah E Kler, L Grisell Diaz-Ramirez, Kira L Ryskina, Sun Young Jeon, Kanan Patel, Thomas K M Cudjoe, Christine S Ritchie, Krista L Harrison, W John Boscardin, Rebecca T Brown

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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.

Sarah E KlerDepartment of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
L Grisell Diaz-RamirezDivision of Geriatrics, University of California San Francisco, San Francisco, California, USA.
Kira L RyskinaDivision of General Internal Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Sun Young JeonDivision of Geriatrics, University of California San Francisco, San Francisco, California, USA.
Kanan PatelDivision of Geriatrics, University of California San Francisco, San Francisco, California, USA.
Thomas K M CudjoeDivision of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-2590-209X
Christine S RitchieDivision of Palliative Care and Geriatric Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Krista L HarrisonDivision of Geriatrics, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0001-5373-3011
W John BoscardinDivision of Geriatrics, University of California San Francisco, San Francisco, California, USA.
Rebecca T BrownDivision of Geriatrics, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0001-7483-4137

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2013 to 2026
$19.9M
UCLA Summer Research Training in Aging for Medical Stud*T35AG026736 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Cathy Lee, John C Newman · 2005 to 2026
$3.0M
Improving Aging in Place for Older Adults Living in Subsidized HousingK76AG057016 · NIA · UNIVERSITY OF PENNSYLVANIA · PI BROWN, REBECCA TYLER · 2018 to 2020
$853k
Palliative Care for People Living at Home with Advancing Dementia and Their CaregiversK01AG059831 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HARRISON, KRISTA LYN · 2019 to 2023
$720k
American Federation for Aging Research K76AG057016Medical Student Training in Aging Research (MSTAR) Program T35AG026736National Institute on Aging at the National Institutes of Health K76AG057016NIA NIH HHS K01 AG059831NIA NIH HHS K76 AG057016NIA NIH HHS L30 AG060590NIA NIH HHS P30 AG044281NIA NIH HHS T35 AG026736Warren Alpert Medical School Scholarly Concentration in Aging Program
6 · The paper itself

Abstract

backgroundNearly 2.9 million older Americans with lower incomes live in subsidized housing. While regional and single-site studies show that this group has higher rates of healthcare utilization compared to older adults in the general community, little is known about healthcare utilization nationally nor associated risk factors.

methodsWe conducted a retrospective cohort study of Medicare beneficiaries aged ≥65 enrolled in the National Health and Aging Trends Study in 2011, linked to Medicare claims data, including individuals living in subsidized housing and the general community. Participants were followed annually through 2020. Outcomes were hospitalization, short-term skilled nursing facility (SNF) utilization, long-term care utilization, and death. Fine-Gray competing risks regression analysis was used to assess the association of subsidized housing residence with hospitalization and nursing facility utilization, and Cox proportional hazards regression analysis was used to assess the association with death.

resultsAmong 6294 participants (3600 women, 2694 men; mean age, 75.5 years [SD, 7.0]), 295 lived in subsidized housing at baseline and 5999 in the general community. Compared to older adults in the general community, those in subsidized housing had a higher adjusted subdistribution hazard ratio [sHR] of hospitalization (sHR 1.21; 95% CI, 1.03-1.43), short-term SNF utilization (sHR 1.49; 95% CI, 1.15-1.92), and long-term care utilization (sHR 2.72; 95% CI, 1.67-4.43), but similar hazard of death (HR, 0.86; 95% CI, 0.69-1.08). Individuals with functional impairment had a higher adjusted subdistribution hazard of hospitalization and short-term SNF utilization and individuals with dementia and functional impairment had a higher hazard of long-term care utilization.

conclusionsOlder adults living in subsidized housing have higher hazards of hospitalization and nursing facility utilization compared to those in the general community. Housing-based interventions to optimize aging in place and mitigate risk of nursing facility utilization should consider risk factors including functional impairment and dementia.

Indexed as

HospitalizationMedicarePatient Acceptance of Health CareAgedAged, 80 and overFemaleHumansLong-Term CareMalePublic HousingRetrospective StudiesSkilled Nursing FacilitiesUnited Statesdementiafunctional impairmenthealthcare utilizationolder adultssubsidized housing

Identifiers

PMID38847363
PMCPMC11323158

What OpenQuestion holds

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Registered trials

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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.