Johanna Katharina Hohls1, Hans-Helmut König1, Hendrik van den Bussche2, Marion Eisele2, Birgitt Wiese3, Anke Oey3, Siegfried Weyerer4, Jochen Werle4, Angela Fuchs5, Michael Pentzek5, Janine Stein6, Susanne Röhr6, Edelgard Mösch7, Horst Bickel7, Kathrin Heser8, Lisa Miebach8, Martin Scherer2, Wolfgang Maier8,9, Steffi G Riedel-Heller6, André Hajek1. 1. Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 2. Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Institute of General Practice, Hannover Medical School, Hannover, Germany. 4. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany. 5. Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. 6. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. 7. Department of Psychiatry, Technical University of Munich, Munich, Germany. 8. Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany. 9. German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Abstract
OBJECTIVE: To analyze the association of anxiety symptoms with health care use and costs in people aged 85 and older. METHODS: Baseline data from AgeQualiDe (N = 856), a multicenter prospective cohort study of primary care patients aged 85 and older, were analyzed. Anxiety symptoms (Geriatric Anxiety Inventory-Short Form) and health care use were assessed via questionnaires. Health care use was monetarily valued using German unit costs to obtain sectoral (inpatient, outpatient, nursing care, medical supplies, and medication) and total costs. Health care use and costs were analyzed in regression models as a function of anxiety symptoms, as well as relevant covariates (predisposing, enabling, and other need characteristics based on the Behavioral Model of Health Care Use). RESULTS: On a descriptive level, people with increased anxiety symptoms (12% of the sample) incurred on average € 10 909 (SD: 16 023) in the last 6 months, 31% more than those without increased anxiety (€ 8303, SD: 11 175; P = 0.12). Adjusting for predisposing, enabling, and other need characteristics, anxiety symptoms were not significantly associated with health care use or costs. Specifically, need characteristics (morbidity, cognitive decline, and functional impairment) were associated with total or sectoral costs, depending on the cost category analyzed. CONCLUSION: In a sample of people of the oldest-old age group, the severity of anxiety symptoms was not associated with health care use or costs, when adjusting for relevant covariates. A longitudinal analysis could assess whether a change in anxiety symptom severity is associated with health care use or costs in old age.
OBJECTIVE: To analyze the association of anxiety symptoms with health care use and costs in people aged 85 and older. METHODS: Baseline data from AgeQualiDe (N = 856), a multicenter prospective cohort study of primary care patients aged 85 and older, were analyzed. Anxiety symptoms (Geriatric Anxiety Inventory-Short Form) and health care use were assessed via questionnaires. Health care use was monetarily valued using German unit costs to obtain sectoral (inpatient, outpatient, nursing care, medical supplies, and medication) and total costs. Health care use and costs were analyzed in regression models as a function of anxiety symptoms, as well as relevant covariates (predisposing, enabling, and other need characteristics based on the Behavioral Model of Health Care Use). RESULTS: On a descriptive level, people with increased anxiety symptoms (12% of the sample) incurred on average € 10 909 (SD: 16 023) in the last 6 months, 31% more than those without increased anxiety (€ 8303, SD: 11 175; P = 0.12). Adjusting for predisposing, enabling, and other need characteristics, anxiety symptoms were not significantly associated with health care use or costs. Specifically, need characteristics (morbidity, cognitive decline, and functional impairment) were associated with total or sectoral costs, depending on the cost category analyzed. CONCLUSION: In a sample of people of the oldest-old age group, the severity of anxiety symptoms was not associated with health care use or costs, when adjusting for relevant covariates. A longitudinal analysis could assess whether a change in anxiety symptom severity is associated with health care use or costs in old age.
Authors: Aarón Salinas-Rodríguez; Betty Manrique-Espinoza; Irina Torres Mussot; Julio Cesar Montañez-Hernández Journal: Front Public Health Date: 2020-07-24