Determinants of death in the hospital among older adults.

TitleDeterminants of death in the hospital among older adults.
Publication TypeJournal Article
Year of Publication2011
AuthorsKelley, A, Ettner, SL, Wenger, NS, Sarkisian, CA
JournalJ Am Geriatr Soc
Date Published2011 Dec
ISSN Number1532-5415
KeywordsAged, Aged, 80 and over, Female, Hospital Mortality, Humans, Male, Multivariate Analysis, Risk Factors, Socioeconomic factors

OBJECTIVES: To investigate patient-level determinants of in-hospital death, adjusting for patient and regional characteristics.

DESIGN: Using multivariable regression, the relationship between in-hospital death and participants' social, functional, and health characteristics was investigated, controlling for regional Hospital Care Intensity Index (HCI) from the Dartmouth Atlas of Health Care.

SETTING: The Health and Retirement Study, a longitudinal nationally representative cohort of older adults.

PARTICIPANTS: People aged 67 and older who died between 2,000 and 2,006 (N = 3,539) were sampled.

MEASUREMENTS: In-hospital death.

RESULTS: Thirty-nine percent (n = 1,380) of participants died in the hospital (range 34% in Midwest to 45% in Northeast). Nursing home residence, functional dependence, and cancer or dementia diagnosis, among other characteristics, were associated with lower adjusted odds of in-hospital death. Being black or Hispanic, living alone, and having more medical comorbidities were associated with greater adjusted odds, as was higher HCI. Sex, education, net worth, and completion of an advance directive did not correlate with in-hospital death.

CONCLUSION: Black race, Hispanic ethnicity, and other functional and social characteristics are correlates of in-hospital death, even after controlling for the role of HCI. Further work must be done to determine whether preferences, provider characteristics and practice patterns, or differential access to medical and community services drive this difference.


Kelley, Amy S Ettner, Susan L Wenger, Neil S Sarkisian, Catherine A United States Journal of the American Geriatrics Society J Am Geriatr Soc. 2011 Dec;59(12):2321-5. doi: 10.1111/j.1532-5415.2011.03718.x. Epub 2011 Nov 8.

User Guide Notes

Endnote Keywords

in-hospital death/in-hospital death/COMORBIDITY/African American/hispanic/Hospital Mortality/Hospital Mortality/Hospital Care Intensity Index/Hospital Care Intensity Index

Endnote ID


Alternate JournalJ Am Geriatr Soc
Citation Key7624
PubMed ID22092014
PubMed Central IDPMC4051314
Grant ListK24 AG022345 / AG / NIA NIH HHS / United States
P30 AG028741 / AG / NIA NIH HHS / United States