Online Program

Health care utilization by older adults with geriatric conditions

Wednesday, November 6, 2013

Feng-Ping Lu, Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
Tzuo-Yun Lan, Institute of Hospital & Health Care Administration, National Yang-Ming University, Taipei, Taiwan
Shwu-Chong Wu, Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
OBJECTIVES: Geriatric conditions were common but often overlooked in clinical practice. We aimed to analyze the patterns of health care utilization and costs associated with geriatric conditions in Taiwan. METHODS: This study used data from the 2005 National Health Interview Survey and concurrent National Health Insurance database to examine the association between geriatric conditions (i.e. cognitive impairment, depressive symptoms, falls, urinary incontinence, and persistent pain) and utilization of outpatient physician services, emergency department (ED) visits, and hospitalizations by older adults aged 65 or over. Multiple specialty visits were defined as more than 4 different specialties visits within one year. Covariates included age, sex, education, urbanization level, chronic diseases, and functional status. Poisson regression was used to model count data. Costs were transformed based on natural log and analyzed by multivariate regression models. RESULTS: 1,760 participants (female 46.8%, mean age 73.6 yr) were enrolled. After adjustment, older adults with two or more geriatric conditions had higher risk of ED visits [risk ratio, 1.6; 95% confidence interval (CI), 1.2-2.2] and costs, but not outpatient physician services and costs. Having two or more geriatric conditions did not associate with higher risk of hospitalizations, but were associated with longer hospital stay. In addition, having two or more geriatric conditions increased risk of multiple specialty visits [adjusted risk ratio, 1.6; 95% CI, 1.1-2.2]. For specific geriatric condition, depressive symptoms were significantly associated with higher health care utilization. CONCLUSIONS: Proper detection and management of geriatric conditions in ambulatory settings may lower the risk of ED visits.

Learning Areas:

Biostatistics, economics
Clinical medicine applied in public health
Public health or related public policy

Learning Objectives:
Describe the patterns of health care utilization by older adults with geriatric conditions.

Keyword(s): Health Care Utilization, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the author or co-author of several journal articles and book chapters focusing on the epidemiology of geriatric conditions. Among my scientific interests has been the development of integrated care models for older adults with geriatric conditions and complex health care needs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.