Factors Associated With Health Service Use Among Older Adults in a Mobile Veterans Program

Area of Science:

• Gerontology
• Health Services Research
• Behavioral Health

Background:

• Older adults, particularly veterans, face unique challenges in accessing healthcare and maintaining independence.
• The Mobile Veterans Program (MVP) aims to support this population, but factors influencing their health service use require examination.
• Andersen's Behavioral Model provides a framework to understand the interplay of predisposing, enabling, and need factors in health service utilization.

Purpose of the Study:

• To investigate how demographic factors, resources (caregiver, MVP), and health needs (cognition, depression) influence hospitalization and institutionalization in older adults using the MVP.
• To apply Andersen's Behavioral Model to older veterans within a community-based support program.
• To identify specific health needs that predict adverse health service use outcomes.

Main Methods:

• Retrospective, longitudinal study design.
• Utilized hierarchical linear modeling (HLM) and growth curve modeling.
• Analyzed data from 54 veterans (aged 55-95) enrolled in the MVP for up to two years.

Main Results:

• Increased depressive symptoms significantly elevated the risk of institutionalization (76%) and hospitalization (40%).
• Enhanced cognitive functioning was associated with a reduced risk of institutionalization (24%).
• Caregiver burden's impact on hospitalization was lessened by more frequent MVP visits.

Conclusions:

• Depressive symptoms and cognitive function are critical predictors of health service use outcomes in older veterans.
• Interventions targeting depressive symptoms may improve health service use and alleviate caregiver burden.
• The frequency of participation in programs like the MVP can mediate the relationship between caregiver burden and hospitalization.