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Open Access Research article

Socioeconomic status and hospitalization in the very old: a retrospective study

Raffaele Antonelli-Incalzi12, Carla Ancona3, Francesco Forastiere3, Valeria Belleudi3, Andrea Corsonello24* and Carlo A Perucci3

Author Affiliations

1 Chair of Geriatric Medicine, University Campus Bio-Medico, Rome, Italy

2 San Raffaele Foundation, Cittadella della Carità, Taranto, Italy

3 Department of Epidemiology, Local Health Authority RME, Rome, Italy

4 Italian National Research Center on Aging (INRCA), Cosenza, Italy

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BMC Public Health 2007, 7:227  doi:10.1186/1471-2458-7-227

Published: 31 August 2007

Abstract

Background

Socioeconomic status could affect the demand for hospital care. The aim of the present study was to assess the role of age, socioeconomic status and comorbidity on acute hospital admissions among elderly.

Methods

We retrospectively examined the discharge abstracts data of acute care hospital admissions of residents in Rome aged 75 or more years in the period 1997–2000. We used the Hospital Information System of Rome, the Tax Register, and the Population Register of Rome for socio-economic data. The rate of hospitalization, modified Charlson's index of comorbidity, and level of income in the census tract of residence were obtained. Rate ratios and 95% confidence limits were computed to assess the relationship between income deciles and rate of hospitalization. Cross-tabulation was used to explore the distribution of the index of comorbidity by deciles of income. Analyses were repeated for patients grouped according to selected diseases.

Results

Age was associated with a marginal increase in the rate of hospitalization. However, the hospitalization rate was inversely related to income in both sexes. Higher income was associated with lower comorbidity. The same associations were observed in patients admitted with a principal diagnosis of chronic condition (diabetes mellitus, heart failure, chron obstructive pulmonary disease) or stroke, but not hip fracture.

Conclusion

Lower social status and associated comorbidity, more than age per se, are associated with a higher rate of hospitalization in very old patients.