PREDICTORS OF HOSPITAL CONTACT BY VERY ELDERLY PEOPLE - A PILOT-STUDYFROM A COHORT OF PEOPLE AGED 75 YEARS AND OVER

We wished to test the hypothesis that elderly people with impaired cog nitive function were heavier users of both outpatient and inpatient ho spital services. In a retrospective cohort study, 144 elderly people a ged 75-97 years (50 men and 94 women) identified from a prevalence sur vey of dementia were traced over an average period of 4 years. They we re categorized into three groups: cognitively impaired, physically fra il and physically healthy. Elderly people with impaired cognitive func tion had fewer contacts with outpatient services (p = 0.0003) but did not differ in inpatient service use from subjects with normal cognitiv e function. Cognitively impaired people who lived alone had longer hos pital stays (p = 0.002) and a higher admission rate to geriatric wards (p = 0.009). Negative self-rated health was an important factor predi cting more contacts for men with inpatient services and geriatric outp atient services (both p = 0.002). Use of surgical outpatient services was associated with use of surgical inpatient services by the physical ly healthy group only (p = 0.0003). After adjusting for age, sex and p hysical health, cognitively impaired subjects were nearly twice as lik ely to die within four years as the other two groups (RR = 1.89).