Evidence map›Paper›PMID 41368129›Full record

ArticleBMJ medicine2025

Household size and its role in the association between multimorbidity and health and social care outcomes in older adults in Wales: retrospective cohort study.

Clare MacRae, Stewart W Mercer, Rhiannon K Owen, Rose Penfold, Stella Arakelyan, Chris Dibben, Jamie Pearce, Andrew Lawson, Nazir I Lone, Karin Modig and 1 more

Abstract read
In one paragraph

Article in BMJ medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Clare MacRaeAdvanced Care Research Centre, University of Edinburgh Usher Institute, Edinburgh, UK.ORCID https://orcid.org/0000-0002-1007-683X
Stewart W MercerAdvanced Care Research Centre, University of Edinburgh Usher Institute, Edinburgh, UK.ORCID https://orcid.org/0000-0002-1703-3664
Rhiannon K OwenSwansea University Medical School, Swansea, UK.
Rose PenfoldAdvanced Care Research Centre, University of Edinburgh Usher Institute, Edinburgh, UK.
Stella ArakelyanAdvanced Care Research Centre, University of Edinburgh Usher Institute, Edinburgh, UK.
Chris DibbenUniversity of Edinburgh School of GeoSciences, Edinburgh, UK.
Jamie PearceUniversity of Edinburgh School of GeoSciences, Edinburgh, UK.
Andrew LawsonUniversity of Edinburgh Usher Institute, Edinburgh, UK.
Nazir I LoneUniversity of Edinburgh Usher Institute, Edinburgh, UK.ORCID https://orcid.org/0000-0003-2707-2779
Karin ModigKarolinska Institute, Stockholm, Sweden.
Bruce GuthrieAdvanced Care Research Centre, University of Edinburgh Usher Institute, Edinburgh, UK.ORCID https://orcid.org/0000-0003-4191-4880

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To examine how the risk of unplanned admission to hospital and transitioning to live in a care home by number of long term conditions varies by household size. Design: Retrospective cohort study. Setting: Wales Census 2011 household data, linked to the Welsh Secure Anonymised Information Linkage (SAIL) Databank, 27 March 2011 to 26 March 2016. Participants: 391 686 residents of Wales recorded in the Wales Census on 27 March 2011, aged ≥65 years, living in Welsh households of one to six residents, registered with a general practitioner contributing data to the SAIL Databank. Main outcome measures: Time to the first unplanned hospital admission and time to transition from living at home in the community to living in a care home, for individuals with 0-1, 2-3, or ≥4 long term conditions living alone or in households with two residents or three or more residents. Results: Of the 391 686 individuals included, 36.8% lived alone, 54.0% lived in households of two, and 9.2% lived in households with three or more people. The number of long term conditions was strongly associated with the risk of hospital admission and transition to a care home. In those living in two person households, participants with ≥4 long term conditions versus those with 0-1 long term conditions had a higher risk of unplanned hospital admissions (adjusted hazard ratio 2.51, 95% confidence interval (CI) 2.47 to 2.55; crude event rate 180.1 (95% CI 178.5 to 181.7) Conclusions: In this study, the number of long term conditions was strongly associated with the risk of hospital admission and transition to living in a care home, and this association was less pronounced among those living alone. The risk of transitioning to live in a care home was higher for people with 0-1 long term conditions who lived alone than for those with 2-3 long term conditions who lived in two person households. These findings emphasise the need for personalised strategies that reduce the risk of unplanned admissions to hospital and support independent living, and that consider both the degree of multimorbidity and household size.

Indexed as

EpidemiologyHealthcare DisparitiesHealth servicesPublic health

Identifiers

PMID41368129
PMCPMC12684141

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.