Home and Community Care Digest

Home and Community Care Digest June 2003 : 0-0

Arthritis patients high users of home health care services

Abstract

Accounting for differences in demographics, comorbidities, and economic factors, older adults with arthritis report greater health care utilization and cost compared with those without arthritis. Considering the fact that there is an increased demand for home care services, the high resource needs of arthritis patients are an important consideration for home care decision makers as arthritis is a cardinal diagnosis among home care clients.
Background: Many studies document that older adults with arthritis are major consumers of medical services. However, many studies do not consider if comorbidities or economic resources have any impact on health service use. This study evaluates the importance of arthritis as a predictor of health care utilization and whether or not comorbidities and economic factors mitigate this role.

Method: Data were analyzed from 6,230 adults aged 70 or older from Asset and Health Dynamic Survey Among the Oldest Old (AHEAD) who responded to the baseline survey in 1993 and in the 1995 interview. The AHEAD is a probability sample of the national population. Baseline data were collected from the report of an arthritis-related physician's visit or a joint replacement not associated with a hip fracture. Controlling for demographic factors, comorbidities (diabetes, cancer, hypertension, heart disease, lunch disease, stroke, and psychiatric problems), and economic resources, multiple logistic regressions were employed in estimating the effect of baseline arthritis on the odds of subsequent 2-year healthcare utilization and out-of-pocket expenses.

Findings: Older patients with arthritis are significantly more likely to have higher health care utilization compared with contemporaries having similar demographics, comorbid conditions, and economic resources, who do not have arthritis. Different health care utilizations investigated in the study include physician visit, hospital admission, outpatient surgery, receiving home health care and having out-of-pocket cost greater than $5,000.

Conclusions: Accounting for differences in demographics, comorbidities, and economic factors, older adults with arthritis reported greater health care utilization and cost compared with those without arthritis. Considering the fact that there is an increased demand for home care services, the high resource needs of arthritis patients are an important consideration for home care decision makers as arthritis is a cardinal diagnosis among home care clients.

Reference: Dunlop DD, Manheim LM, Song J, Chang RW. Health Care Utilization Among Older Adults With Arthritis. Arthritis Care and Research 2003; 49(2):164-171.

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