Effects of Mobility and Multimorbidity on Inpatient and Postacute Health Care Utilization

Kristine E. Ensrud, Li Yung Lui, Lisa Langsetmo, Tien N. Vo, Brent C. Taylor, Peggy M. Cawthon, Meredith L. Kilgore, Charles E. McCulloch, Jane A. Cauley, Marcia L. Stefanick, Kristine Yaffe, Eric S. Orwoll, John T. Schousboe

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations


Background This study examines effects of mobility and multimorbidity on hospitalization and inpatient and postacute care (PAC) facility days among older men. Methods Prospective study of 1,701 men (mean age 79.3 years) participating in Osteoporotic Fractures in Men (MrOS) Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high. Hospitalizations and PAC facility stays ascertained during 12 months following Y7. Results Reduced mobility and greater multimorbidity burden were independently associated with a higher risk of inpatient and PAC facility utilization, after accounting for each other and traditional indicators. Adjusted mean total facility days per year were 1.13 (95% confidence interval [CI] = 0.74-1.40) among men with good mobility increasing to 2.43 (95% CI = 1.17-3.84) among men with poor mobility, and 0.67 (95% CI = 0.38-0.91) among men without multimorbidity increasing to 2.70 (95% CI = 1.58-3.77) among men with high multimorbidity. Men with poor mobility and high multimorbidity had a ninefold increase in mean total facility days per year (5.50, 95% CI = 2.78-10.87) compared with men with good mobility without multimorbidity (0.59, 95% CI = 0.37-0.95). Conclusions Among older men, mobility limitations and multimorbidity were independent predictors of higher inpatient and PAC utilization after considering each other and conventional predictors. Marked combined effects of reduced mobility and multimorbidity burden may be important to consider in clinical decision-making and planning health care delivery strategies for the growing aged population.

Original languageEnglish (US)
Pages (from-to)1343-1349
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number10
StatePublished - Sep 11 2018

Bibliographical note

Publisher Copyright:
© Published by Oxford University Press on behalf of The Gerontological Society of America 2017.


  • Gait speed
  • Hospitalization
  • Multimorbidity
  • Older men
  • Postacute care


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