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Predicting admissions and time spent in hospital over a decade in a population-based record linkage study: the EPIC-Norfolk cohort.


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Authors

Hayat, Shabina 
Khaw, KT 

Abstract

OBJECTIVE: To quantify hospital use in a general population over 10 years follow-up and to examine related factors in a general population-based cohort. DESIGN: A prospective population-based study of men and women. SETTING: Norfolk, UK. PARTICIPANTS: 11,228 men and 13,786 women aged 40-79 years in 1993-1997 followed between 1999 and 2009. MAIN OUTCOMES MEASURES: Number of hospital admissions and total bed days for individuals over a 10-year follow-up period identified using record linkage; five categories for admissions (from zero to highest ≥ 7) and hospital bed days (from zero to highest ≥ 20 nights). RESULTS: Over a period of 10 years, 18,179 (72.7%) study participants had at least one admission to hospital, 13.8% with 7 or more admissions and 19.9% with 20 or more nights in hospital. In logistic regression models with outcome ≥ 7 admissions, low education level OR 1.14 (1.05 to 1.24), age OR per 10-year increase 1.75 (1.67 to 1.82), male sex OR 1.32 (1.22 to 1.42), manual social class 1.22 (1.13 to 1.32), current cigarette smoker OR 1.53 (1.37 to 1.71) and body mass index >30 kg/m² OR 1.41 (1.28 to 1.56) all independently predicted the outcome with p<0.0001. Results were similar for those with ≥ 20 hospital bed days. A risk score constructed using male sex, manual social class, no educational qualifications; current smoker and body mass index >30 kg/m², estimated percentages of the cohort in the categories of admission numbers and hospital bed days in stratified age bands with twofold to threefold differences in future hospital use between those with high-risk and low-risk scores. CONCLUSIONS: The future probability of cumulative hospital admissions and bed days appears independently related to a range of simple demographic and behavioural indicators. The strongest of these is increasing age with high body mass index and smoking having similar magnitudes for predicting risk of future hospital usage.

Description

Keywords

EPIDEMIOLOGY, HEALTH SERVICES ADMINISTRATION & MANAGEMENT, PUBLIC HEALTH, Adult, Age Factors, Aged, Body Mass Index, Demography, Educational Status, Female, Health Behavior, Hospitalization, Hospitals, Humans, Length of Stay, Life Style, Logistic Models, Male, Middle Aged, Patient Admission, Prospective Studies, Risk Factors, Sex Factors, Smoking, Social Class, United Kingdom

Journal Title

BMJ Open

Conference Name

Journal ISSN

2044-6055
2044-6055

Volume Title

6

Publisher

BMJ
Sponsorship
Medical Research Council (G1000143)
Medical Research Council (G0401527)
MRC (MC_PC_13048)
Cancer Research Uk (None)
Cancer Research Uk (None)
The design and conduct of the EPIC-Norfolk study and collection and management of the data was supported by programme grants from the Medical Research Council UK (G9502233, G0401527) and Cancer Research UK (C864/A8257, C864/A2883).