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Understanding poor health behaviours as predictors of different types of hospital admission in older people: findings from the Hertfordshire Cohort Study

Understanding poor health behaviours as predictors of different types of hospital admission in older people: findings from the Hertfordshire Cohort Study
Understanding poor health behaviours as predictors of different types of hospital admission in older people: findings from the Hertfordshire Cohort Study
BACKGROUND:Rates of hospital admission are increasing, particularly among older people. Poor health behaviours cluster but their combined impact on risk of hospital admission among older people in the UK is unknown.

METHODS: 2997 community-dwelling men and women (aged 59-73) participated in the Hertfordshire Cohort Study (HCS). We scored (from 0 to 4) number of poor health behaviours engaged in at baseline (1998-2004) out of: current smoking, high weekly alcohol, low customary physical activity and poor diet. We linked HCS with Hospital Episode Statistics and mortality data to 31/03/2010 and analysed associations between the score and risk of different types of hospital admission: any; elective; emergency; long stay (>7?days); 30-day readmission (any, or emergency).

RESULTS: 32%, 40%, 20% and 7% of men engaged in 0, 1, 2 and 3/4 poor health behaviours; corresponding percentages for women 51%, 38%, 9%, 2%. 75% of men (69% women) experienced at least one hospital admission. Among men and women, increased number of poor health behaviours was strongly associated (p<0.01) with greater risk of long stay and emergency admissions, and 30-day emergency readmissions. Hazard ratios (HRs) for emergency admission for 3/4 poor health behaviours in comparison with none were: men, 1.37 (95% CI 1.11 to 1.69); women, 1.84 (95% CI 1.22 to 2.77). Associations were unaltered by adjustment for age, body mass index and comorbidity.

CONCLUSIONS: Clustered poor health behaviours are associated with increased risk of hospital admission among older people in the UK. Lifecourse interventions to reduce number of poor health behaviours could have substantial beneficial impact on health and use of healthcare in later life.
0143-005X
292-298
Syddall, H.E.
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Westbury, L.D.
5ed45df3-3df7-4bf9-bbad-07b63cd4b281
Simmonds, S.J.
2214e6b5-868a-4dae-8491-fca5d5a8ecb8
Robinson, S.
ba591c98-4380-456a-be8a-c452f992b69b
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Sayer, A.A.
f4c60d4a-ae9c-4633-890f-598a717a61d4
Syddall, H.E.
a0181a93-8fc3-4998-a996-7963f0128328
Westbury, L.D.
5ed45df3-3df7-4bf9-bbad-07b63cd4b281
Simmonds, S.J.
2214e6b5-868a-4dae-8491-fca5d5a8ecb8
Robinson, S.
ba591c98-4380-456a-be8a-c452f992b69b
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Sayer, A.A.
f4c60d4a-ae9c-4633-890f-598a717a61d4

Syddall, H.E., Westbury, L.D., Simmonds, S.J., Robinson, S., Cooper, C. and Sayer, A.A. (2016) Understanding poor health behaviours as predictors of different types of hospital admission in older people: findings from the Hertfordshire Cohort Study. Journal of Epidemiology & Community Health, 70 (3), 292-298. (doi:10.1136/jech-2015-206425). (PMID:26481495)

Record type: Article

Abstract

BACKGROUND:Rates of hospital admission are increasing, particularly among older people. Poor health behaviours cluster but their combined impact on risk of hospital admission among older people in the UK is unknown.

METHODS: 2997 community-dwelling men and women (aged 59-73) participated in the Hertfordshire Cohort Study (HCS). We scored (from 0 to 4) number of poor health behaviours engaged in at baseline (1998-2004) out of: current smoking, high weekly alcohol, low customary physical activity and poor diet. We linked HCS with Hospital Episode Statistics and mortality data to 31/03/2010 and analysed associations between the score and risk of different types of hospital admission: any; elective; emergency; long stay (>7?days); 30-day readmission (any, or emergency).

RESULTS: 32%, 40%, 20% and 7% of men engaged in 0, 1, 2 and 3/4 poor health behaviours; corresponding percentages for women 51%, 38%, 9%, 2%. 75% of men (69% women) experienced at least one hospital admission. Among men and women, increased number of poor health behaviours was strongly associated (p<0.01) with greater risk of long stay and emergency admissions, and 30-day emergency readmissions. Hazard ratios (HRs) for emergency admission for 3/4 poor health behaviours in comparison with none were: men, 1.37 (95% CI 1.11 to 1.69); women, 1.84 (95% CI 1.22 to 2.77). Associations were unaltered by adjustment for age, body mass index and comorbidity.

CONCLUSIONS: Clustered poor health behaviours are associated with increased risk of hospital admission among older people in the UK. Lifecourse interventions to reduce number of poor health behaviours could have substantial beneficial impact on health and use of healthcare in later life.

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Accepted/In Press date: 2 October 2015
e-pub ahead of print date: 19 October 2015
Published date: March 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 388181
URI: http://eprints.soton.ac.uk/id/eprint/388181
ISSN: 0143-005X
PURE UUID: 27169c72-c42d-445f-bd89-59beef88036f
ORCID for H.E. Syddall: ORCID iD orcid.org/0000-0003-0171-0306
ORCID for S. Robinson: ORCID iD orcid.org/0000-0003-1766-7269
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 19 Feb 2016 16:35
Last modified: 18 Feb 2021 16:51

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Contributors

Author: H.E. Syddall ORCID iD
Author: L.D. Westbury
Author: S.J. Simmonds
Author: S. Robinson ORCID iD
Author: C. Cooper ORCID iD
Author: A.A. Sayer

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