TRENDS IN ELDERLY MORTALITY MORBIDITY &HOSPITAL USE

  • Leibson, Cynthia L (PI)

Project: Research project

Project Details

Description

Recent increases in age-specific survival among the elderly are expected to
generate enormous demands for health care. Predictions of the extent of
these demands, however are hampered by a death of empirical data on time-
trends in age-specific morbidity and the impact of these changes on
utilization. A valuable opportunity to investigate such trends exists with
the unique medical records linkage system of the Rochester Epidemiology
Project (REP) and the demonstrated capacity for population-based
epidemiologic and health services research in Olmsted County, MN. Over the
past 2 decades Olmsted County has mirrored the U.S. in that mortality rates
have declined for persons > 65 years of age, while hospital use rates have
increased, especially among the oldest old. These observations provide
provisional support for the argument that greater demands for health care
services will accompany increased longevity as a result of higher levels of
age-specific morbidity. This proposal begins to tap the potential of the
REP for testing this hypothesis by focusing specifically on individuals
characterized by the chronic disease, non-insulin dependent diabetes
mellitus (NIDDM). This retrospective, longitudinal study will compare 3
prevalence cohorts consisting of all Rochester, MN, residents > 45 with a
diagnosis of NIDDM as of January for the years 1970, 1980, 1990.
Individuals will be followed from data of prevalence until 1/1/94.
Differences among cohorts for age-specific survival and duration of NIDDM
will be estimated, as will the association between survival and 2 distinct
measures of morbidity: (1) incidence of comorbidity following date of
prevalence, and (2) a summary measure of morbidity defined as overall
disease severity. Cohorts will be compared for risk of hospitalization and
hospitalization incidence density. Disease duration, morbidity, and
hospital use rates will be determined with review of patient-based medical
records (outpatient and inpatient). Multiple regression and Cox
proportional hazards models will be employed to determine trends in the
independent association between overall morbidity and hospital utilization.
Extensive experience in REP studies of numerous diseases verifies the
ability to determine appropriate clinical and epidemiologic parameters and
to provide nearly 100% follow-up to 1/1/94 for each of the prevalence
cohorts. This retrospective study of clinically defined disease and
hospitalization rates will also provide a foundation for future prospective
studies of active life expectancy and long term care use.
StatusFinished
Effective start/end date9/30/907/31/96

Funding

  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health

ASJC

  • Medicine(all)

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