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Published on: September 30, 2020
Changes in hospitalisation rates in older people before and after moving to a retirement village
Katherine Bloomfield1,2, Zhenqiang Wu1, Michal Boyd3
1Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Objectives:
An increasing proportion of older people live in Retirement Villages ('villages'). This population cites support for health-care issues as one reason for relocation to villages. Here, we examine whether relocation to villages is associated with a decline in hospitalisations.
Methods:
Retrospective, before-and-after observational study.
Setting:
Retirement villages, Auckland, New Zealand.
Participants:
466 cognitively intact village residents (336 [72%] female); mean (SD) age at moving to village was 73.9 (7.7) years. Segmented linear regression analysis of an interrupted time-series design was used.
Main Outcome Measures:
all hospitalisations for 18 months pre- and postrelocation to village.
Secondary Outcome:
acute hospitalisations during the same time periods.
Results:
The average hospitalisation rate (per 100 person-years) was 44.9 (95% confidence interval [CI] = 36.3-55.6) 18-10 months before village relocation, 58.9 (95% CI = 48.3-72.0) 9-1 months before moving, 47.9 (95% CI = 38.8-59.1) 1-9 months after moving and 62.4 (95% CI = 51.2-76.0) 10-18 months after moving. Monthly average hospitalisation rate (per 100 person-years) increased before relocation to village by an average of 1.2 (95% CI = 0.01-1.57, p = .04) per month from 18 to 1 month before moving, and there was a change in the level of the monthly average hospitalisation rate immediately after relocation (mean difference [MD] = -18.4 per 100 person-years, 95% CI = -32.8 to -4.1, p = .02). The trend change after village relocation did not differ significantly from that before moving.
Conclusions:
Although we cannot reliably claim causality, relocation to a retirement village is, for older people, associated with a significant but non-sustained reduction in hospitalisation.
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