Julia L. Finkelstein, BSc, MPH (2005), Department of Community Health, Brown University, Health and Wellness Division, Blue Cross & Blue Shield of Rhode Island, Campus Box G, Brown University Medical School, Providence, RI 02912, 401-421-4982, Julia_Finkelstein@Brown.edu, Maria C. Donahue, MPH, MSW, Health and Wellness Division, Blue Cross & Blue Shield of Rhode Island, 444 Westminster Street, Providence, RI 02903, and Michael Manocchia, PhD, QualityMetric Incorporated, 640 George Washington Highway, Lincoln, RI 02865.

BACKGROUND: The association between stress burden and health-related quality of life, medical condition management and health care utilization was evaluated among a Medicare insured, senior population (>= 65 years of age). METHODS: A health risk assessment [HRA] questionnaire was administered to a randomly selected group of Medicare participants from a single health plan. The data was collected from May to June 2002, and resulted in a 40% response rate, representing 1022 surveys. Bi-variate and general linear regression models were performed to evaluate the association between HRA variables: stress burden, physical health status, emotional health, level of functioning, medical condition management, and health care utilization. RESULTS: Using a multivariable linear regression model, individuals with higher levels of reported stress had increased presence (p<.0001), frequency (p<.0001), and discomfort (p<.0001) of self-reported physical symptoms, greater number of medical conditions (p<.0001) and lower scores on overall emotional health (p<.0001). Increased self-reported stress was also associated with decreased physical (p<.0001), social (p<.0001), and overall (p<.0001) ability to function, and higher levels of pain (p=.0012) and fatigue (p=.0004). Those with greater levels of stress had decreased medical compliance (p<.0001), reduced ability to manage medical conditions (p<.0001), increased hospitalization (p=.0013), and greater number of days at home due to illness in the past 6 months (p=.015). CONCLUSIONS: These findings indicate a strong association between stress, health-related quality of life, management of medical conditions, and health care utilization, in a senior population. Health plans should be cognizant of the relationship between stress level and critical health outcome variables.

Learning Objectives:

• • Describe the association between stress levels, health-related quality of life, management of medical conditions and health care utilization within a senior population (>=65 years of age).
  • Identify areas where increased public health knowledge of stress and health indicators is necessary, and particularly relevant in a senior population.
  • Recognize the need in health plans for addressing stress burden in health interventions to promote health-related quality of life among elderly populations.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.