Hospitalization of elderly people. A 3-year controlled trial

In a controlled epidemiologic intervention study, preventive home visits to elderly people aged 75 or older were made very third month over 3 years. Two hundred eighty-five (62% women) elderly participated in the intervention group and 287 (62% women) in the control group. Information about the number of admissions to hospitals, the number of bed days, the main reason for hospitalization, the diagnoses on discharge, and the residence after discharge was collected. Two hundred nineteen admissions (4,884 bed days) were registered for the intervention group compared with 271 (6,442 bed days) for the control group. During the second half of the study, a significant reduction in the number of admissions--especially readmissions--to hospitals was seen in the intervention group. The mean risk per person of being hospitalized was 24%, 20%, and 20% in years 1, 2, and 3, respectively, for the intervention group, and 22%, 25%, and 28% for the controls. The mean number of bed days per admission did not differ between the two groups. Using the results to make a general epidemiologic and longitudinal assessment of the admissions of elderly aged 75 or older, the following can be concluded: 4% of the participants used 42% of the bed days, and most of these people awaited alternative residential accommodation; 62% stayed less than 2 weeks in the hospital. The main reason for hospitalization was fall episodes among women (20%) and dyspnea among men (18%). Approximately three-fourths were discharged to their own homes or to the family, while 18% died. Preventive home visits seem to be one of the tools to improve the future lives of the elderly in their own homes.