Scott R Beach1, Richard Schulz1, Esther M Friedman2, Juleen Rodakowski3, Grant Martsolf4, Alton Everette James5. 1. University Center for Social and Urban Research, University of Pittsburgh. 2. Pardee RAND Graduate School. 3. School of Health and Rehabilitation Sciences, University of Pittsburgh. 4. School of Nursing, University of Pittsburgh. 5. Health Policy Institute, University of Pittsburgh.
Abstract
Objectives: We explore adverse consequences of unmet needs for care among high-need/high-cost (HNHC) older adults. Method: Interviews with 4,024 community-dwelling older adults with ADL/IADL/mobility disabilities from the 2011 National Health and Aging Trends Study (NHATS). Reports of socio-demographics, disability compensatory strategies, and adverse consequences of unmet needs in the past month were obtained from older adults with multiple chronic conditions (MCC), probable dementia (DEM), and/or near end-of-life (EOL) and compared older adults not meeting these criteria. Results: Older adults with MCC (31.6%), DEM (39.6%), and EOL (48.7%) reported significantly more adverse consequences than low-need older adults (21.4%). Persons with MCC & DEM (53.4%), MCC & EOL (53.2%), and all three (MCC, DEM, EOL, 65.6%) reported the highest levels of adverse consequences. HNHC participants reported more environmental modifications, assistive device, and larger helper networks. HNHC status independently predicted greater adverse consequences after controlling for disability compensatory strategies in multivariate models. Discussion: Adverse consequences of unmet needs for care are prevalent among HNHC older adults, especially those with multiple indicators, despite more disability-related compensatory efforts and larger helper networks. Helping caregivers provide better informal care has potential to contain healthcare costs by reducing hospitalization and unplanned readmissions.
Objectives: We explore adverse consequences of unmet needs for care among high-need/high-cost (HNHC) older adults. Method: Interviews with 4,024 community-dwelling older adults with ADL/IADL/mobility disabilities from the 2011 National Health and Aging Trends Study (NHATS). Reports of socio-demographics, disability compensatory strategies, and adverse consequences of unmet needs in the past month were obtained from older adults with multiple chronic conditions (MCC), probable dementia (DEM), and/or near end-of-life (EOL) and compared older adults not meeting these criteria. Results: Older adults with MCC (31.6%), DEM (39.6%), and EOL (48.7%) reported significantly more adverse consequences than low-need older adults (21.4%). Persons with MCC & DEM (53.4%), MCC & EOL (53.2%), and all three (MCC, DEM, EOL, 65.6%) reported the highest levels of adverse consequences. HNHC participants reported more environmental modifications, assistive device, and larger helper networks. HNHC status independently predicted greater adverse consequences after controlling for disability compensatory strategies in multivariate models. Discussion: Adverse consequences of unmet needs for care are prevalent among HNHC older adults, especially those with multiple indicators, despite more disability-related compensatory efforts and larger helper networks. Helping caregivers provide better informal care has potential to contain healthcare costs by reducing hospitalization and unplanned readmissions.
Authors: Jennifer M Reckrey; R Sean Morrison; Kathrin Boerner; Sarah L Szanton; Evan Bollens-Lund; Bruce Leff; Katherine A Ornstein Journal: J Am Geriatr Soc Date: 2019-11-06 Impact factor: 5.562
Authors: Erin D Bouldin; Christopher A Taylor; Kenneth A Knapp; Christina E Miyawaki; Nicholas R Mercado; Karen G Wooten; Lisa C McGuire Journal: Int Psychogeriatr Date: 2020-09-04 Impact factor: 7.191