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Physicians drive the decision to hospitalize older individuals. Yet, informal caregivers also influence hospital use among the elderly, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health.
For the study, which was supported in part by the Agency for Healthcare Research and Quality (T32 HS00029), Jennifer L. Wolff, Ph.D., and Judith D. Kasper, Ph.D., analyzed data from a sample of 420 disabled elderly women receiving informal care from friends or relatives. The subjects and their caregivers had participated in the Women's Health and Aging Study and its accompanying Caregiving Survey. The objective was to examine caregiver attributes with respect to the women's hospitalization experiences.
Care recipients were more likely to be hospitalized but less likely to be delayed in discharge from the hospital if caregivers felt competent in their role. Nearly half (49 percent) of care recipients were never hospitalized over 3 years. Those who were hospitalized tended to be older, were in worse self-reported health, had more task limitations, and had a cardiopulmonary condition or diabetes. Care recipients with primary caregivers who were more involved in their medical care were 53 percent more likely to be hospitalized after controlling for sociodemographic and health factors.
Concerned family and friends who are familiar with medical providers or more confident in their abilities may be more apt to contact providers in the face of new or worsening symptoms which, in turn, may lead to hospitalization. The average length of stay among hospitalized women was 6.2 days. Thirty percent of the women remained in the hospital more than 2 days beyond the average stay for their diagnosis, which was considered a delay in discharge.
Details are in "Informal caregiver characteristics and subsequent hospitalization outcomes among recipients of care," by Drs. Wolff and Kasper, in the August 2004 Aging Clinical and Experimental Research 16(4), pp. 307-313.
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