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APHA Scientific Session and Event Listing

Luisa Franzini, PhD, Management, policy and community health, University of Texas School of Public Health, 1200 Pressler Drive, Houston, TX 77401, 713 500 9487, Luisa.Franzini@uth.tmc.edu and Carmel Bitondo Dyer, MD, Quentin Mease Community Hospital, Baylor College of Medicine, 3601 North MacGregor Way, Houston, TX 77004.

Self-neglect among the elderly is the most common problem faced by Adult Protective Services (APS) and has been shown to be a risk factor for death. Little is known about health care utilization and costs in this population. We investigated health care utilization and cost in 131 cases of self-neglectors (30 cases had additional types of mistreatment) who were referred to a geriatric medicine team (GMT) by APS in Houston, TX during 2002 and 2003. A matched-case control design was used to compare utilization and costs in the year before and after evaluation by the GMT. Controls were patients using geriatric services from the same GMT and were matched by gender, race/ethnicity, and age. Medical diagnoses, utilization (number of clinic visits, number of house calls, number of hospital stays and length of stay per hospitalization), intensity of care based on CPT codes, and medical care costs (physician, outpatient, and inpatient Medicare reimbursable costs) were compared in the two groups before and after the GMT evaluation. Mental health diagnoses were more frequent among self-neglectors than controls. In the year before the GMT evaluation, self-neglecters had significantly lower utilization and medical care costs. In the year following the evaluation, there was no difference in utilization and costs in the two groups. There were no differences in intensity of care for those receiving care in the two groups. In conclusion, once self-neglectors are brought into the medical care system, they do not have higher utilization or costs than other patients their age.

Learning Objectives: At the conclusion of this session, the participant will be able to

• List indicators for self-neglect in the elderly.
• Articulate the procedure to compare health care utilization and costs in self-neglectors and controls.
• Describe differences in health care utilization and costs in self-neglectors and controls.

Keywords: Access and Services, Cost Issues

Presenting author's disclosure statement:

Not Answered