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Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home
Clare MacRae 
,
Stewart W. Mercer,
Eleojo Abubakar,
Andrew Lawson ,
Nazir Lone ,
Anna Rawlings ,
Jane Lyons,
Ronan Lyons,
Amy Mizen ,
Rich Fry ,
Gergő Baranyi,
Jamie Pearce,
Chris Dibben,
Karin Modig,
Rhiannon Owen ,
Bruce Guthrie
,
Stewart W. Mercer,
Eleojo Abubakar,
Andrew Lawson ,
Nazir Lone ,
Anna Rawlings ,
Jane Lyons,
Ronan Lyons,
Amy Mizen ,
Rich Fry ,
Gergő Baranyi,
Jamie Pearce,
Chris Dibben,
Karin Modig,
Rhiannon Owen ,
Bruce Guthrie
Nature Communications, Volume: 16, Start page: 1718
Swansea University Authors:
Anna Rawlings , Jane Lyons, Ronan Lyons, Amy Mizen , Rich Fry , Rhiannon Owen
-
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DOI (Published version): 10.1038/s41467-025-56990-9
Abstract
The ability to manage ill health and care needs might be affected by who a person lives with. This study examined how the risk of unplanned hospitalisation and transition to living in a care home varied according to household size and co-resident multimorbidity. Here we show results from a cohort st...
| Published in: | Nature Communications |
|---|---|
| ISSN: | 2041-1723 |
| Published: |
Springer Nature
2025
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa68925 |
| first_indexed |
2025-02-19T12:33:38Z |
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| last_indexed |
2025-02-20T11:19:11Z |
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SURis |
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This study examined how the risk of unplanned hospitalisation and transition to living in a care home varied according to household size and co-resident multimorbidity. Here we show results from a cohort study using Welsh nationwide linked healthcare and census data, that employed multilevel multistate models to account for the competing risk of death and clustering within households. The highest rates of unplanned hospitalisation and care home transition were in those living alone. Event rates were lower in all shared households and lowest when co-residents did not have multimorbidity. These differences were more substantial for care home transition. Therefore, living alone or with co-residents with multimorbidity poses additional risk for unplanned hospitalisation and care home transition beyond an individual’s sociodemographic and health characteristics. Understanding the mechanisms behind these associations is necessary to inform targeted intervention strategies.</abstract><type>Journal Article</type><journal>Nature Communications</journal><volume>16</volume><journalNumber/><paginationStart>1718</paginationStart><paginationEnd/><publisher>Springer Nature</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2041-1723</issnElectronic><keywords/><publishedDay>17</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2025</publishedYear><publishedDate>2025-02-17</publishedDate><doi>10.1038/s41467-025-56990-9</doi><url/><notes/><college>COLLEGE NANME</college><department>Biosciences</department><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>Medical Research Council MR/W000253/1 fellowship for C.M.; National Institute for Health Research (NIHR) Artificial Intelligence and Multimorbidity for B.G. and S.W.M.: Clustering in Individuals, Space and Clinical Context (AIM-CISC) grant NIHR202639; Legal and General plc funding for the Advanced Care Research Centre for B.G. and S.W.M.</funders><projectreference/><lastEdited>2025-02-19T12:36:46.7635568</lastEdited><Created>2025-02-19T12:24:13.5695374</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Clare</firstname><surname>MacRae</surname><orcid>0000-0002-1007-683X</orcid><order>1</order></author><author><firstname>Stewart W.</firstname><surname>Mercer</surname><order>2</order></author><author><firstname>Eleojo</firstname><surname>Abubakar</surname><order>3</order></author><author><firstname>Andrew</firstname><surname>Lawson</surname><orcid>0000-0002-8751-4551</orcid><order>4</order></author><author><firstname>Nazir</firstname><surname>Lone</surname><orcid>0000-0003-2707-2779</orcid><order>5</order></author><author><firstname>Anna</firstname><surname>Rawlings</surname><orcid>NULL</orcid><order>6</order></author><author><firstname>Jane</firstname><surname>Lyons</surname><orcid/><order>7</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><order>8</order></author><author><firstname>Amy</firstname><surname>Mizen</surname><orcid>0000-0001-7516-6767</orcid><order>9</order></author><author><firstname>Rich</firstname><surname>Fry</surname><orcid>0000-0002-7968-6679</orcid><order>10</order></author><author><firstname>Gergő</firstname><surname>Baranyi</surname><order>11</order></author><author><firstname>Jamie</firstname><surname>Pearce</surname><order>12</order></author><author><firstname>Chris</firstname><surname>Dibben</surname><order>13</order></author><author><firstname>Karin</firstname><surname>Modig</surname><order>14</order></author><author><firstname>Rhiannon</firstname><surname>Owen</surname><orcid>0000-0001-5977-376X</orcid><order>15</order></author><author><firstname>Bruce</firstname><surname>Guthrie</surname><orcid>0000-0003-4191-4880</orcid><order>16</order></author></authors><documents><document><filename>68925__33646__7128fc1ccbcb4e6da31e4b8c869d7544.pdf</filename><originalFilename>68925.VOR.pdf</originalFilename><uploaded>2025-02-19T12:32:21.4980764</uploaded><type>Output</type><contentLength>645607</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© The Author(s) 2025. 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2025-02-19T12:36:46.7635568 v2 68925 2025-02-19 Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home 46366e9ea4e8840d8c216e76c2f85204 NULL Anna Rawlings Anna Rawlings true true 1b74fa5125a88451c52c45bcf20e0b47 Jane Lyons Jane Lyons true false 83efcf2a9dfcf8b55586999d3d152ac6 Ronan Lyons Ronan Lyons true false 9e9db8229784e27fcd79a14ee097e10b 0000-0001-7516-6767 Amy Mizen Amy Mizen true false d499b898d447b62c81b2c122598870e0 0000-0002-7968-6679 Rich Fry Rich Fry true false 0d30aa00eef6528f763a1e1589f703ec 0000-0001-5977-376X Rhiannon Owen Rhiannon Owen true false 2025-02-19 The ability to manage ill health and care needs might be affected by who a person lives with. This study examined how the risk of unplanned hospitalisation and transition to living in a care home varied according to household size and co-resident multimorbidity. Here we show results from a cohort study using Welsh nationwide linked healthcare and census data, that employed multilevel multistate models to account for the competing risk of death and clustering within households. The highest rates of unplanned hospitalisation and care home transition were in those living alone. Event rates were lower in all shared households and lowest when co-residents did not have multimorbidity. These differences were more substantial for care home transition. Therefore, living alone or with co-residents with multimorbidity poses additional risk for unplanned hospitalisation and care home transition beyond an individual’s sociodemographic and health characteristics. Understanding the mechanisms behind these associations is necessary to inform targeted intervention strategies. Journal Article Nature Communications 16 1718 Springer Nature 2041-1723 17 2 2025 2025-02-17 10.1038/s41467-025-56990-9 COLLEGE NANME Biosciences COLLEGE CODE Swansea University Another institution paid the OA fee Medical Research Council MR/W000253/1 fellowship for C.M.; National Institute for Health Research (NIHR) Artificial Intelligence and Multimorbidity for B.G. and S.W.M.: Clustering in Individuals, Space and Clinical Context (AIM-CISC) grant NIHR202639; Legal and General plc funding for the Advanced Care Research Centre for B.G. and S.W.M. 2025-02-19T12:36:46.7635568 2025-02-19T12:24:13.5695374 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Clare MacRae 0000-0002-1007-683X 1 Stewart W. Mercer 2 Eleojo Abubakar 3 Andrew Lawson 0000-0002-8751-4551 4 Nazir Lone 0000-0003-2707-2779 5 Anna Rawlings NULL 6 Jane Lyons 7 Ronan Lyons 8 Amy Mizen 0000-0001-7516-6767 9 Rich Fry 0000-0002-7968-6679 10 Gergő Baranyi 11 Jamie Pearce 12 Chris Dibben 13 Karin Modig 14 Rhiannon Owen 0000-0001-5977-376X 15 Bruce Guthrie 0000-0003-4191-4880 16 68925__33646__7128fc1ccbcb4e6da31e4b8c869d7544.pdf 68925.VOR.pdf 2025-02-19T12:32:21.4980764 Output 645607 application/pdf Version of Record true © The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). true eng http://creativecommons.org/licenses/by/4.0/ |
| title |
Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home |
| spellingShingle |
Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home Anna Rawlings Jane Lyons Ronan Lyons Amy Mizen Rich Fry Rhiannon Owen |
| title_short |
Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home |
| title_full |
Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home |
| title_fullStr |
Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home |
| title_full_unstemmed |
Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home |
| title_sort |
Impact of household size and co-resident multimorbidity on unplanned hospitalisation and transition to care home |
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46366e9ea4e8840d8c216e76c2f85204 1b74fa5125a88451c52c45bcf20e0b47 83efcf2a9dfcf8b55586999d3d152ac6 9e9db8229784e27fcd79a14ee097e10b d499b898d447b62c81b2c122598870e0 0d30aa00eef6528f763a1e1589f703ec |
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46366e9ea4e8840d8c216e76c2f85204_***_Anna Rawlings 1b74fa5125a88451c52c45bcf20e0b47_***_Jane Lyons 83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons 9e9db8229784e27fcd79a14ee097e10b_***_Amy Mizen d499b898d447b62c81b2c122598870e0_***_Rich Fry 0d30aa00eef6528f763a1e1589f703ec_***_Rhiannon Owen |
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Anna Rawlings Jane Lyons Ronan Lyons Amy Mizen Rich Fry Rhiannon Owen |
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Clare MacRae Stewart W. Mercer Eleojo Abubakar Andrew Lawson Nazir Lone Anna Rawlings Jane Lyons Ronan Lyons Amy Mizen Rich Fry Gergő Baranyi Jamie Pearce Chris Dibben Karin Modig Rhiannon Owen Bruce Guthrie |
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The ability to manage ill health and care needs might be affected by who a person lives with. This study examined how the risk of unplanned hospitalisation and transition to living in a care home varied according to household size and co-resident multimorbidity. Here we show results from a cohort study using Welsh nationwide linked healthcare and census data, that employed multilevel multistate models to account for the competing risk of death and clustering within households. The highest rates of unplanned hospitalisation and care home transition were in those living alone. Event rates were lower in all shared households and lowest when co-residents did not have multimorbidity. These differences were more substantial for care home transition. Therefore, living alone or with co-residents with multimorbidity poses additional risk for unplanned hospitalisation and care home transition beyond an individual’s sociodemographic and health characteristics. Understanding the mechanisms behind these associations is necessary to inform targeted intervention strategies. |
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2025-02-17T05:28:37Z |
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