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Utilization patterns of cohorts of elderly clients: a structural equation model
1Department of Medical Ecology, Hebrew University-Hadassah, School of Public Health and Community Medicine, Jerusalem, Israel.
Health Services Research
|June 1, 1994
Summary
Elderly males and females exhibit distinct health service use patterns. Admission to long-term care increases specialist visits but reduces acute hospital care utilization.
Area of Science:
- Gerontology
- Health Services Research
- Biostatistics
Background:
- Understanding health service utilization patterns in elderly populations is crucial for effective healthcare planning.
- Previous models often fail to capture the interrelationships between various health service utilization variables.
Purpose of the Study:
- To identify a statistical model that accounts for the interrelationships among health service utilization variables.
- To examine the health service utilization patterns of elderly clients before and after admission to a long-term care program.
Main Methods:
- Utilized administrative data from the British Columbia Ministry of Health for elderly clients.
- Employed the LISREL model to analyze fifteen utilization variables (GP visits, specialist visits, lab tests, hospital stays) over one year pre- and post-admission to long-term care.
- Linked three computer databases to create a comprehensive client record.
Main Results:
- A robust model was identified, demonstrating the interconnectedness of health service utilization variables.
- General practitioner emergency room visits significantly impact hospital stay, with a substantial portion of this effect being indirect.
- Specialist consultations mediate the relationship between primary care visits and hospital admissions.
Conclusions:
- Significant differences in health service utilization exist between elderly males and females.
- Age had minimal impact on utilization for males and a small impact for females.
- Long-term care admission led to increased specialist consultations and diagnostic/surgical procedure use, but decreased acute hospital care utilization.