Early Hospital Management of Ageing Disease: Retrospective Study From a National Claims Database

Speaker(s)

Vimont A1, Leleu H2, Durand-Zaleski I3
1Public Health Expertise, paris, France, 2Public Health Expertise, Paris, France, 3DRCI-URC Eco Ile-de-France (AP-HP), Assistance Publique-Hôpitaux de Paris, Paris, France

OBJECTIVES:

Reducing the burden of late-life morbidity requires an understanding of the mechanisms of ageing-related diseases (ARDs), but also of their early healthcare management. This study aimed at exploring the evolution of age at index admission for ARD to provide better understanding of their management.

METHODS:

We used a representative sample (1/97th) of the French National Health Data Information System (SNDS), which gathered medical claims from around 700,000 insured individuals. We pre-selected 35 ARDs identified from the literature and grouped them into 12 groups of ARDs, including kidney disease, rheumatological diseases, eye diseases, neurological diseases, mental disorders, endocrinal disorders, hemopathy, urothelial disorders, tissue diseases, cardiovascular diseases, respiratory disease, and cancer. Index admission for patient with an ARD was retrieved (with a minimum 5-year wash-out period) and pooled into three different 3-year periods (2011-2013, 2014-2016, 2017-2019). Incident rates and distributions of age at onset of ARD were compared between periods, for each ARD group.

RESULTS:

Incidence rates for any ARD ranged from 16.8 to 14.4 per 1,000 patient-year from the period 2011-13 to 2017-19 respectively. Median age at onset of ARDs decreased from 71 years in 2011 to 69 years old in 2019. For most of ARD groups, age at index admission decreased with time, associated to an increasing proportion of ambulatory admission. Early hospital management was particularly significant for cancer, rheumatological diseases, eye diseases, respiratory diseases, and cardiovascular diseases.

CONCLUSIONS:

Patients with ARDs tended to be managed earlier at hospital, reflecting a better patient management care and most likely imputable to ambulatory shift. More studies are warranted to understand the mechanisms leading to the diseases of ageing.

Code

EPH47

Topic

Epidemiology & Public Health, Real World Data & Information Systems

Topic Subcategory

Health & Insurance Records Systems

Disease

SDC: Mental Health (including addition), SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), SDC: Neurological Disorders, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)