Elder abuse as a risk factor for hospitalization in older persons.
Elder abuse as a risk factor for hospitalization in older persons.
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DOI：
10.1001/jamainternmed.2013.238
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发表时间：
2013-05-27
影响因子：
39
通讯作者：
Simon, Melissa A.
中科院分区：
文献类型：
--
作者：
Dong, XinQi;Simon, Melissa A.
虐待老年人与死亡风险增加有关。然而，虐待老年人与保健服务利用之间的关系仍不清楚。研究老年人社区居住人口中总体虐待老年人与特定虐待老年人亚型和住院率之间的关系。前瞻性基于人群的研究。芝加哥健康与老龄化项目。在参加芝加哥健康与老龄化项目的6674名居住在社区的老年人中，106名被社会服务机构确定为虐待老年人。主要预测因素是向社会服务机构报告的虐待老年人（报告和确认）。研究的结果是从医疗保险和医疗补助服务中心获得的年住院率。泊松回归模型用于评估这些纵向关系。未经调整的平均年住院率，无虐待老人者为0.62 (95% CI, 0.59-0.66)，有虐待老人报告者为1.97 （95% CI, 1.33-2.61）。在调整了社会人口统计学和社会经济变量、医疗合并症、认知和身体功能以及心理社会健康后，报告的虐待老年人的住院率更高（比率比[RR]， 2.00 [95% CI, 1.45-2.75]）。在考虑相同的潜在混杂因素后，心理虐待（RR, 2.22 [95% CI, 1.44-3.43]）、经济剥削（RR, 1.75 [95% CI, 1.06-2.90]）、照顾者忽视（RR, 2.43 [95% CI, 1.60-3.69]）和2种或更多类型的老年人虐待（RR, 2.59 [95% CI, 1.82-3.66]）与住院率增加相关。相互作用项分析的结果表明，虐待老年人与住院之间的关联在医疗合并症、认知和功能障碍或心理社会困扰的水平上没有差异。虐待老年人与该社区人口住院率上升有关。未来的研究需要探索虐待老年人与住院之间的因果机制。随着我们进入医疗改革时代，更好地了解提高住院率的因素也可能对社会和卫生政策以及弱势患者的临床护理产生重大影响。
Elder abuse is associated with increased mortality risk. However, the relationship between elder abuse and health care services utilization remains unclear. To examine the relationship between overall elder abuse and specific subtypes of elder abuse and rate of hospitalization in a community-dwelling population of older adults. Prospective population-based study. Chicago Health and Aging Project. Of the 6674 community-dwelling older adults who participated in the Chicago Health and Aging Project, 106 were identified by social services agencies for elder abuse The primary predictor was elder abuse (reported and confirmed) reported to social services agency. The outcome of interest was the annual rate of hospitalization obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. The unadjusted mean annual rate of hospitalization was 0.62 (95% CI, 0.59–0.66) for those without elder abuse and 1.97 (95% CI, 1.33–2.61) for those with reported elder abuse. After adjusting for sociodemographic and socioeconomic variables, medical comorbidities, cognitive and physical function, and psychosocial wellbeing, reported elder abuse had higher rates of hospitalization (rate ratio [RR], 2.00 [95% CI, 1.45–2.75]). Psychological abuse (RR, 2.22 [95% CI, 1.44–3.43]), financial exploitation (RR, 1.75 [95% CI, 1.06–2.90]), caregiver neglect (RR, 2.43 [95% CI, 1.60–3.69]), and 2 or more types of elder abuse (RR, 2.59 [95% CI, 1.82–3.66]) were associated with increased rates of hospitalization, after considering the same potential confounders. Results from interaction term analyses suggested that the association between elder abuse and hospitalization did not differ across the levels of medical comorbidities, cognitive and functional impairment, or psychosocial distress. Elder abuse was associated with increased rates of hospitalization in this community population. Future research is needed to explore the causal mechanisms between elder abuse and hospitalization. As we enter the era of health care reform, an improved understanding of factors that increase rates of hospitalization could also have significant implications for social and health policy as well as clinical care of the vulnerable patients.
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影响因子：
3.4
作者：
KATZ, S;AKPOM, CA
通讯作者：
AKPOM, CA
影响因子：
3.5
作者：
Dong, X. Q.;Simon, M. A.;Evans, D. A.
通讯作者：
Evans, D. A.
DOI：
10.1111/j.1532-5415.2007.01429.x
发表时间：
2007-11-01
影响因子：
6.3
作者：
Dong, Xinqi;Simon, Melissa A.;Golden, Robyn
通讯作者：
Golden, Robyn
DOI：
10.1111/j.1532-5415.2012.04147.x
发表时间：
2012-10-01
影响因子：
6.3
作者：
Dong, XinQi;Simon, Melissa;Evans, Denis
通讯作者：
Evans, Denis
影响因子：
2.6
作者：
Mitchell, Suzanne E.;Paasche-Orlow, Michael K.;Jack, Brian W.
通讯作者：
Jack, Brian W.