Analysis of the Use of Hospital Services by the Elderly, in Romania, in 2019

Abstract

Population aging is a phenomenon with a strong dynamic, which requires a constant concern of health policies in order to make the most effective and efficient decisions for this population segment. The health needs of the elderly have many age-specific features, and records of patterns of hospital use by the elderly population can support the decision-making process. The purpose of the analysis was to identify the main models in the use of hospital services, by analyzing the causes of hospitalization and in-hospital death in the elderly, over 65 years, in Romania.

METHOD. The DRGNational database was investigated in order to select hospitalization episodes for the elderly in 2019. All hospitals that reported patientlevel data were included. Data on the main diagnosis and discharge status were extracted, as well as other variables that allowed the analysis of demographic characteristics.

calls for the formulation of economic and health policies in line with the needs of the elderly related to their economic and social protection, specific health services and home care for people with disabilities or various forms of disability, and the elderly without family support.

RESULTS. The most common major categories of hospitalization that required hospitalization of patients over 65 years were: diseases and disorders of the circulatory system, diseases and disorders of the musculoskeletal system and connective tissue, diseases and disorders of the nervous system. Among the most common cardiovascular diseases, hospitalized patients presented with congestive heart failure, valvopathies such as mitral regurgitation or primary hypertension as the main diagnosis of hospitalization. The pattern of frequent use can be summarized as follows: women with an average age of 77 years, from rural areas, who needed an average length of hospitalization of 8 days, most patients being discharged as ameliorated, while a fifth died.

Most in-hospital deaths occurred in the elderly hospitalized for diseases and disorders of the circulatory system (a quarter of the total), diseases and disorders of the nervous system (about one-fifth) and diseases and disorders of the respiratory system (over one-tenth of the total). Pattern of the elderly who died in the hospital: the average age of 78 years, most of them came from urban areas, with a slight predominance of women.

Among cardiovascular diseases, the most common deaths were recorded in patients with the main diagnosis: unspecified cardiac arrest, congestive heart failure, dilated cardiomyopathy, but also acute myocardial infarction, sudden heart death, or heart failure. Patients who died with such diagnoses had an average age of 78 years, women predominated, came mostly from urban areas and were hospitalized for an average of 11 days.

CONCLUSIONS. The in-depth analysis of hospital activity must provide an overview, but at the same time a comparative picture of the causes of hospitalization and in-hospital death by age groups (children, adults, the elderly). Decisions on the allocation of resources and their use at the hospital sector level must be supported by valid, up-to-date records, and taking into account the particularities in the use of hospital services by older age groups.