249462 Hospitalizations in the Alaskan elderly: 15-year trends in demographics and health care utilization

Wednesday, November 2, 2011: 9:06 AM

Kenneth K. H. Chui, PhD, MS/MPH , Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Steven A. Cohen, DrPH, MPH , Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Cheryl Rosa, DVM, PhD , U.S. Arctic Research Commission, Anchorage, AK
Ekaterina Naumova, BA , Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Elena N. Naumova, PhD , Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA
Alaska state is rapidly growing and aging: the population of Alaska has doubled from 302,583 in 1970 to 698,473 in 2010; in the same period of time, the size of the elderly population (≥65 year-old) has increased by 8-fold, compared to 2-fold nationally. Epidemiologic analysis of morbidity among Alaskan elderly can guide in optimal delivery of health services.

We abstracted hospitalization records from 1991 to 2006 acquired from the Centers of Medicare and Medicaid Services and compared the hospitalization patterns of Alaskan elderly with national profiles formed using the US Census and intercensal estimates. We compared rate of population growth, total hospitalization charge, and 16-year temporal trends for major hospitalization use: cancers; respiratory and cardiovascular diseases; gastroenteric infections, mental disorders, and injuries.

We found that in Alaska the elderly population is highly localized in major cities. Rate of hospitalization has exceeded the growth rate of the elderly population (75% vs. 27%) in the studied time span. Increase in hospitalization charge is most profound for the younger elderly aged 65-75. While primary causes for hospitalization have not changed, a 7% drop and an 11.2% increases were observed in cardiovascular diseases and infections, respectively. The rate of hospitalization associated with mental disorders increased from 591 to 940/10,000 elderly from 1991 to 2006 (vs. the national 480 to 1194/10,000 elderly).

Alaska faces unique challenges for achieving healthy aging. Public health programs targeted at older adults in Alaska should consider the rapid change in the demographic structure.

Learning Areas:
Epidemiology
Program planning
Provision of health care to the public

Learning Objectives:
Discuss the temporal trends in demography and morbidity from 1991-2006 in Alaska elderly population. Identify population subsets and health conditions that deserve more attention, action, and resource when promoting healthy aging in Alaska. Formulate actions, in practice and research, which are likely to facilitate the understanding and realization of aging in Alaska.

Keywords: Aging, Health Care Utilization

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was trained in biostatistics and epidemiology and have more than 5 years of experience analyzing US elderly hospitalization records.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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