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Challenge to long-term care for the elderly: cold-weather impacts institutional population more than community-dwelling population

Journal of the American Medical Directors Association. 13(9): 788-793. 2012.
Chau P.H., Wong M. and Woo J.


To examine whether cold weather affects the institutional population more than the community-dwelling population in terms of morbidity requiring hospital admission.

Residence-based hospital discharge data were used to compile excess winter hospitalization (EWH) index for the older population (aged 65 years and above) living in institutions (residential care home for the elderly [RCHE] population) and the community-dwelling elderly population in Hong Kong. To separate the influence of influenza on the cold-related hospital admissions, episodes because of influenza were excluded from this study.

In 2009, the EWH index for the RCHE population was 22.93% (95% CI: 20.80%-25.09%), which was much higher than that for the community-dwelling population (14.09%, 95% CI: 13.11%-15.08%). The EWH index was higher among RCHE population compared with community-dwelling population across different age groups and sex (paired t-test one-tailed P= .014).

The institutional elderly population was more vulnerable to the risk of excess hospitalization in winter. There may be room for improvement in the living environment of institutions, in particular the ambient temperature and personal care, to reduce hospital admissions. Given the expanding institutional population, the limited hospital beds, and long waiting queue for accident and emergency services, prevention of cold-related hospitalization would help to reduce the medical care burden.

Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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