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Cited by 501Nursing care and researchPalliative Care and End-of-Life IssuesHealth disparities and outcomes

The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.

Mortality after the Hospitalization of a Spouse

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Christakis, Nicholas A., Allison, Paul D.·2006·New England Journal of Medicine
DOI 10.1056/nejmsa050196
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Abstract

BACKGROUND: The illness of a spouse can affect the health of a caregiving partner. We examined the association between the hospitalization of a spouse and a partner's risk of death among elderly people. METHODS: We studied 518,240 couples who were enrolled in Medicare in 1993. We used Cox regression analysis and fixed-effects (case-time-control) methods to assess hospitalizations and deaths during nine years of follow-up. RESULTS: Overall, 383,480 husbands (74 percent) and 347,269 wives (67 percent) were hospitalized at least once, and 252,557 husbands (49 percent) and 156,004 wives (30 percent) died. Mortality after the hospitalization of a spouse varied according to the spouse's diagnosis. Among men, 6.4 percent died within a year after a spouse's hospitalization for colon cancer, 6.9 percent after a spouse's hospitalization for stroke, 7.5 percent after a spouse's hospitalization for psychiatric disease, and 8.6 percent after a spouse's hospitalization for dementia. Among women, 3.0 percent died within a year after a spouse's hospitalization for colon cancer, 3.7 percent after a spouse's hospitalization for stroke, 5.7 percent after a spouse's hospitalization for psychiatric disease, and 5.0 percent after a spouse's hospitalization for dementia. After adjustment for measured covariates, the risk of death for men was not significantly higher after a spouse's hospitalization for colon cancer (hazard ratio, 1.02; 95 percent confidence interval, 0.95 to 1.09) but was higher after hospitalization for stroke (hazard ratio, 1.06; 95 percent confidence interval, 1.03 to 1.09), congestive heart failure (hazard ratio, 1.12; 95 percent confidence interval, 1.07 to 1.16), hip fracture (hazard ratio, 1.15; 95 percent confidence interval, 1.11 to 1.18), psychiatric disease (hazard ratio, 1.19; 95 percent confidence interval, 1.12 to 1.26), or dementia (hazard ratio, 1.22; 95 percent confidence interval, 1.12 to 1.32). For women, the various risks of death after a spouse's hospitalization were similar. Overall, for men, the risk of death associated with a spouse's hospitalization was 22 percent of that associated with a spouse's death (95 percent confidence interval, 17 to 27 percent); for women, the risk was 16 percent of that associated with death (95 percent confidence interval, 8 to 24 percent). CONCLUSIONS: Among elderly people hospitalization of a spouse is associated with an increased risk of death, and the effect of the illness of a spouse varies among diagnoses. Such interpersonal health effects have clinical and policy implications for the care of patients and their families.

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  1. Hatten J, 1980, Health Care Financ Rev, 2, 53
  2. Pope GC, 1998, Health Care Financ Rev, 20, 109

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Metadata

Authors
Christakis, N. A., & Allison, P. D.
Affiliations
  • Harvard University (US)
  • University of Pennsylvania (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2006-02-16
Volume
354
Issue
7
Pages
719-730
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmsa050196
OpenAlex
W2031439369
Cited by
501
References
38
Citations by year
2026: 6 · 2025: 10 · 2024: 13 · 2023: 10 · 2022: 11 · 2021: 20 · 2020: 18 · 2019: 14 · 2018: 16 · 2017: 60 · 2016: 25 · 2015: 29 · 2014: 34 · 2013: 35 · 2012: 32
FWCI
93.90
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
National Institute on Aging (R-01AG17548-01, R01AG017548)
Topics
  • Health Sciences › Nursing › Research and Theory › Nursing care and research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Social Sciences › Health › Health disparities and outcomes
Keywords
spousal caregiving, older couples, hospitalization, colon cancer, stroke, dementia, mental illness, congestive heart failure, hip fracture, sex differences
MeSH terms
Aged, Bereavement, Female, Follow-Up Studies, Medicare, Hospitalization, Humans, Male, Mortality, Risk, United States, Proportional Hazards Models, Odds Ratio, Case-Control Studies, Caregivers, Spouses

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