Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T00:44:06.605Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric Morbidity and Service Use Among Elderly People

Published online by Cambridge University Press:  14 November 2008

Ann Bowling  and
Morag Farquhar
Ann Bowling
Affiliation:
Senior Lecturer, Needs Assessment Unit, Joint Department of General Practice and Primary Health Care, The London Hospital Medical College and St Bartholomew's Medical School, London
Morag Farquhar
Affiliation:
Research Fellow
Get access Rights & Permissions [Opens in a new window]

Abstract

There is some evidence in the literature of increased demand on health services by adults with psychiatric morbidity. Among people over retirement age these associations appear weaker. Results from three independent, but comparable, surveys of elderly people living in London and Essex are presented in relation to their use of health and social services. Psychiatric morbidity was found to be a poor predictor of service use. Level of functional ability and, in some cases, age were both stronger predictors of use of a selection of these services among the two samples from the urban area. Age was a stronger predictor of use of home help and meals on wheels services among the younger urban sample aged 65–85. The model had little explanatory power in relation to use of general practitioner services. The study also indicated that the semi-rural sample had better reported health status and functional ability than the samples in the urban area. Use of health and social services was also lower in the semi-rural areas.

Type
Research Article
Information
Ageing & Society , Volume 11 , Issue 3 , September 1991 , pp. 275 - 297
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

NOTES

1 Cornoni-Huntley, J. C., Foley, D. J., White, L. R. et al. , Epidemiology of disability in the oldest old: methodologic issues and preliminary findings. Milbank Memorial Fund Quarterly, 63 (1985), 350–76.CrossRefGoogle ScholarPubMed

2 Martin, J., Meltzer, H. and Elliot, D., The Prevalence of Disability in Great Britain. OPCS surveys of disability in Great Britain, Report 1. Her Majesty's Stationery Office, London, 1988.Google Scholar

3 Salvage, A. and Vetter, N., Awareness of and satisfaction with community services in a random sample of over 75s. Health Trends, 20 (1988), 88–92.Google Scholar

4 Lubitz, J. and Prihoda, R., Use and costs of medicare services in the last two years of life. Health Care Financing Review, 20 (1984), 117–31.Google Scholar

5 Office of Population Censuses and Surveys, General Household Survey, 1977 and 1987. OPCS, London, 1979–89.Google Scholar

6 Wenger, G. C., The Supportive Network. Coping with Old Age. National Institute of Social Work Library No. 46. George Allen and Unwin, London, 1984.Google Scholar

7 Townsend, P., The effects of family structure on the likelihood of admission to an institution in old age: the application of a general theory. In Shanas, E., and Streib, G. F. (eds), Social Structure and the Family. Prentice Hall, Englewood Cliffs, 1965.Google Scholar

8 Shanas, E., The family as a social support system in old age. The Gerontologist, 19 (1979), 169–74.CrossRefGoogle ScholarPubMed

9 Bowling, A. and Cartwright, A., Life after a Death. A Study of the Elderly Widowed. Tavistock Publications, London, 1982.Google Scholar

10 Johnson, R. E., Mullooly, J. P. and Greenlick, M. R., Morbidity and medical care utilisation of old and very old persons. Health Services Research, 25 (1990), 639–65.Google Scholar

11 Linn, S., Linn, M. W. and Knopka, F., The very old patient in ambulatory care. Medical Care, 16 (1978), 604–10.CrossRefGoogle ScholarPubMed

12 Soldo, B. J. and Manton, K. G., Health status and service needs of the oldest old: current patterns and future trends. Milbank Memorial Fund Quarterly, 63 (1985), 286–319.CrossRefGoogle ScholarPubMed

13 Wolinsky, F. D., Mosely, R. R. and Coe, R. M., A cohort analysis of the use of health services by elderly Americans. Journal of Health and Social Behaviour, 27 (1986), 209–19.CrossRefGoogle ScholarPubMed

14 Roos, N., Shapiro, E. and Roos, L. L. Jr, Aging and the demand for health services: which aged and whose demand? The Gerontologist, 24 (1984), 1–6.CrossRefGoogle ScholarPubMed

15 Roos, N. P. and Shapiro, E., The Manitoba longitudinal study on aging. Medical Care, 19 (1981), 6–57.CrossRefGoogle ScholarPubMed

16 Densen, P. M., Shapiro, S. and Einhorn, M., Concerning high and low utilizers of services in a medical care plan, and the persistence of utilization levels over a three year period. Milbank Memorial Fund Quarterly, 37 (1959), 219–50.CrossRefGoogle Scholar

17 McCall, N. and Wai, H. S., An analysis of the use of Medicare services by the continuously enrolled aged. Medical Care, 21 (1983), 567–85.CrossRefGoogle ScholarPubMed

18 Freeborn, D. K., Pope, C. R., Mullooly, J. P. and McFarland, B. H., Consistently high users of medical care among the elderly. Medical Care, 28 (1990), 526–40.CrossRefGoogle ScholarPubMed

19 Scitovsky, A., The high cost of dying: what do the data show? Milbank Memorial Fund Quarterly, 62 (1984), 591–608.CrossRefGoogle Scholar

20 Johnson, R. E., Mullooly, J. P. and Greenlick, M. R., Morbidity and medical care utilisation of old and very old persons. Health Services Research, 25 (1990), 639–65.Google Scholar

21 Andersen, R., A Behavioural Model of Families' Use of Health Services. Center for Health Administration Studies, University of Chicago, Chicago, Il. 1968.Google Scholar

22 Hibbard, J. H. and Pope, C. R., Age differences in the use of medical care in an HMO: an application of the behavioural model. Medical Care, 24 (1986), 52–66.CrossRefGoogle Scholar

23 McFarland, B. H., Freeborn, D. K., Mullooly, J. P.et al., Utilisation patterns among long term enrollees in a pre-paid group practice HMO. Medical Care, 23 (1985), 1221–33.CrossRefGoogle Scholar

24 Wan, T. T., The behavioural model of health care utilisation by older people. In Ory, M. G. and Bond, K., Aging and Health Care: Social Science and Policy Perspectives. Routledge, New York, 1989.Google Scholar

25 Ford, G. G., Illness behaviour in the elderly. In Dean, K., Hickey, T. and Holstein, B. B. (eds), Self Care and Health in Old Age. Croom Helm, Dover, NH, 1986.Google Scholar

26 McFarland, B. H., Freeborn, D. K., Mullooly, J. P. et al. , Utilisation and mortality of HMO enrollees. Medical Care, 24 (1986), 200–208.CrossRefGoogle Scholar

27 Waxman, H. M., Carner, E. A., Blum, A. et al. , Depressive symptoms and health services utilisation among the community elderly. Journal of the American Geriatric Society, 31 (1982), 417–20.CrossRefGoogle Scholar

28 Berkanovic, E., Hurwicz, M. and Landsverk, J., Psychological distress and the decision to seek medical care. Social Science arid Medicine, 27 (1988), 1215–21.CrossRefGoogle ScholarPubMed

29 Bradburn, N. M., The Structure of Psychological Well-Being. Aldine Publishing, Chicago, 1969.Google Scholar

30 Morgan, K., Dallosso, H., Ebrahim, S. et al. , Mental health and contact with primary care services in old age. International Journal of Geriatric Psychiatry, 2 (1987), 223–6.CrossRefGoogle Scholar

31 Bowling, A., Contact with general practitioners and differences in health status among people aged over 85 years. Journal of the Royal College of General Practitioners, 39 (1989), 52–5.Google ScholarPubMed

32 Bowling, A., The prevalence of psychiatric morbidity among people aged 85 and over living at home. Associations with reported somatic symptoms and consulting behaviour. Social Psychiatry and Psychiatric Epidemiology, 25 (1990), 132–40.CrossRefGoogle ScholarPubMed

33 Bedford, A., Foulds, G. A. and Sheffield, B. F., A new personal disturbance scale (DSSI/SAD). British Journal of Social and Clinical Psychology, 15 (1976), 387–94.CrossRefGoogle Scholar

34 Goldberg, D., Manual of the General Health Questionnaire. NFER-Nelson Publishing Company, Windsor, 1978.Google Scholar

35 Stewart, A. L., Greenfield, S., Hays, R. D. et al. , Functional status and wellbeing of patients with chronic conditions. Results from the medical outcomes study. Journal of the American Medical Association, 262 (1989), 907–13.CrossRefGoogle Scholar

36 Wells, K. B., Stewart, A., Hays, R. D. et al. , The functioning and well-being of depressed patients. Results from the medical outcomes study. Journal of the American Medical Association, 262 (1989), 914–18.CrossRefGoogle ScholarPubMed

37 Jarman, B., Deprivation Data: Yorth East Thames Regional Health Authority. St Mary's Hospital Medical School, Department of General Practice, London, 1987.Google Scholar

38 Cartwright, A. and Anderson, R., General Practice Revisited. A Second Study of Patients and their Doctors. Tavistock Publications, London, 1981.Google Scholar

39 Todd, J. and Butcher, R., Electoral Registration in 1981. Office of Population Censuses and Surveys, London, 1987.Google Scholar

40 Cartwright, A., Health Surveys. King's Fund, London, 1983.Google Scholar

41 Townsend, P., Poverty in Britain. Penguin, Harmondsworth, 1979.Google Scholar

42 Hirsch, B. J., Natural support systems and coping with major life changes. American Journal of Community Psychology, 8 (1980), 159–72.CrossRefGoogle Scholar

43 Stokes, J. P., Predicting satisfaction with social support from social network structure. American Journal of Community Psychology, 11 (1983), 141–52.CrossRefGoogle Scholar

44 Andrews, F. M. and Withey, S. B., Social Indicators of Well Being – Americans' Perceptions of Life Quality. Plenum Press, New York, 1976.CrossRefGoogle Scholar

45 Neugarten, B. L., Havighurst, R. J. and Tobin, S. S., Measurement of life satisfaction. Journal of Gerontology, 16 (1961), 134–43.CrossRefGoogle ScholarPubMed

46 Nie, N. H., Statistical Package for the Social Sciences (Xth version). McGraw Hill Book Company, New York, 1983.Google Scholar

47 Scialfa, C. T. and Games, P. A., Problems with step-wise regression in research on aging and recommended alternatives. Journal of Gerontology, 42 (1987), 579–83.CrossRefGoogle ScholarPubMed

48 Blaxter, M. and Patterson, L., Mothers and Daughters: A Three Generational Study of Health Attitudes and Behaviour. Heinemann, London, 1982.Google Scholar

49 Williams, R., A Protestant Legacy. Clarendon Press, Oxford, 1990.Google Scholar