Care Dependence and Hospitalizations: Evidence from the Mexican Health and Aging Study

We study the effect of care dependence on hospitalizations among older persons in Mexico, analyzing data from the Mexican Health and Aging Study (MHAS) from 2001 to 2021. We use fixed-effects logistic regression to estimate the likelihood of hospitalization during the last year (yes/no) and high-dimensional fixed-effects models to assess its duration (number of nights at the hospital). Our analysis reveals that difficulties with Activities of Daily Living (ADLs) and/or Instrumental Activities of Daily Living (IADLs) increase both the risk and the duration of hospitalizations. Key findings include a significant increase in the likelihood of hospitalization, by: 47.9% for individuals with 1-2 ADL impairments (relative to persons without impairments); 75.4% for individuals with 3 or more ADL impairments; 40.6% for individuals with 1-2 IADL impairments; 49.8% for individuals with 3 or more IADL impairments. We also find evidence of a significant effect on the duration of the hospitalization (conditional on being hospitalized), that increase by 13.4% for persons with 1-2 ADL impairments, and 22.7% for individuals with 3 or more ADL impairments. These results underscore the necessity for targeted interventions that reduce both the frequency and duration of hospitalizations among older persons with care needs, for example through greater integration between healthcare and long-term care services.