Co-occurrence of serious illnesses common in old age, ups healthcare utilization

Some 40 percent of older adults seem to have multiple concomitant diagnoses for serious illnesses, a recent study has found. Such co-occurrence in turn increases their risk of healthcare utilization at the end of life.

Drawing from the Rochester Epidemiology Project, researchers assessed data from 1,372 adults who had died between July 1, 2017 and June 30, 2018 at ≥65 years of age and who were considered to be seriously ill. Healthcare utilization was defined as the number of emergency department (ED), hospital, and intensive care unit (ICU) stays in the last 6 months and 30 days of life. Analyses were stratified according to the number of co-occurring serious illnesses.

Participants had an average age of 84 years and 52 percent were women. Around 40 percent were found to have multiple, concomitant serious illnesses.

During the last 6 months of life, 35 percent of seriously ill older adults had at least one ED visit, 69 percent at least one hospitalization, and 29 percent at least one ICU stay. Corresponding utilization rates for the last 30 days of life were 10 percent, 41 percent, and 18 percent.

Adjusted analyses further revealed that those who had at least two serious illnesses were 1.28 times more likely to visit the ED during the last 6 months of life than those with only one such condition. This likelihood jumped to 1.84 among those with ≥3 serious illnesses. Similarly, the likelihood of needing to be admitted to the hospital or ICU increased with an increasing number of co-occurring serious illness.

“Having multiple serious illness diagnoses is common at the end of life and increases the risk of end-of-life healthcare utilization,” the researchers said. “Older adults with multiple serious illness diagnoses may benefit from interventions focused on discussing care priorities.”