With an ageing population, understanding leading causes of hospitalisation in older adults is critical for care strategies. These leading causes may vary across residential settings and by seasonal patterns. This study examines the temporal trends of leading causes of hospitalisation among older adults in community-dwelling and nursing home settings, specifically comparing patterns during winter and summer seasons.

A retrospective analysis of electronic medical records from Hong Kong public hospitals (2012–2018) was conducted for three million adults aged ≥65. Age-standardised and sex-standardised monthly hospitalisation rates and average annual percentage change (AAPC, representing the average yearly percentage change in rates) were examined for leading causes during summer and winter across settings.

Among community-dwelling individuals, the top five causes in 2018 were symptoms, signs and abnormalities not classified elsewhere (NEC), neoplasms, genitourinary, circulatory and respiratory diseases in winter, with digestive diseases replacing respiratory diseases in summer. Symptoms, signs and abnormalities NEC (AAPC: 2.7% (95% CI 1.8% to 3.6%) in winter; 3.4% (2.8% to 4.0%) in summer), neoplasms (2.4% (1.4% to 3.4%) in winter; 2.5% (1.6% to 3.4%) in summer), genitourinary (2.5% (2.1% to 2.9%) in winter; 2.4% (1.8% to 3.0%) in summer) and digestive diseases (2.5% (1.6% to 3.3%) in winter; 2.6% (1.7% to 3.5%) in summer) increased, while circulatory diseases decreased in winter. In nursing home residents, the top five causes in 2018 were respiratory diseases, symptoms, signs and abnormalities NEC, genitourinary, circulatory and digestive diseases in winter and summer. Symptoms, signs and abnormalities NEC increased (2.9% (0.9% to 5.0%) in winter; 2.9% (0.8% to 5.1%) in summer), while circulatory diseases declined across seasons. Genitourinary diseases remained stable across seasons, whereas digestive diseases declined in winter.

In Hong Kong’s ageing population, seasonal and temporal shifts in hospitalisation causes were observed. Symptoms, signs and abnormalities NEC emerged as the top two causes across settings, highlighting challenges for primary care and hospital management and need for enhanced prevention and care strategies.

Autism and neurodevelopmental disorders (NDDs) are complex conditions that manifest as significant impairments in social communication and behaviour. Early detection and intervention play a pivotal role in improving outcomes, largely due to the high brain plasticity in infants. The PRECO-TSA study aims to validate the effectiveness of systematic use of the Prévention de l’Autisme (PREAUT) grid for early screening and referral strategies for autism and NDDs in infants, focusing on a coordinated approach that integrates maternal and child protection centre with medical-psychological centres. The goal is to evaluate a streamlined referral system to improve early detection and facilitate effective interventions for children at higher risk of autism.

The PRECO-TSA study is a prospective, pragmatic, multicentre, cluster-randomised controlled trial using an incomplete stepped-wedge design, which maximises external validity. The study includes a 6-month baseline phase, a 3-month semiobservation phase and a 6-month follow-up phase. The 36-month patient inclusion period is followed by a 48-month passive follow-up through the National Health Data System, data collection includes demographic and clinical information, with hierarchical mixed models used to analyse the impact of early screening and referral for autism and NDDs.

This study was funded by the French Ministry of Health (PREPS-20-0186) and was approved by Ile de France I Ethics Committee CPP (number CPPIDF1-2023-DI29-Cat2). The results will be submitted for publication in peer-reviewed journals.

NCT05815095.