Cargando…

Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities

Background: Older adults with disability are frequent users of the emergency department (ED) and often rely on family caregiver support. We identify whether and which caregiver characteristics are associated with older adults’ ED use. Methods: We use Cox proportional hazards regression to model the...

Descripción completa

Detalles Bibliográficos
Autores principales: Burgdorf, Julia, Mulcahy, John, Amjad, Halima, Kasper, Judith D., Covinsky, Kenneth, Wolff, Jennifer L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764037/
https://www.ncbi.nlm.nih.gov/pubmed/31550971
http://dx.doi.org/10.1177/2150132719875636
_version_ 1783454292283228160
author Burgdorf, Julia
Mulcahy, John
Amjad, Halima
Kasper, Judith D.
Covinsky, Kenneth
Wolff, Jennifer L.
author_facet Burgdorf, Julia
Mulcahy, John
Amjad, Halima
Kasper, Judith D.
Covinsky, Kenneth
Wolff, Jennifer L.
author_sort Burgdorf, Julia
collection PubMed
description Background: Older adults with disability are frequent users of the emergency department (ED) and often rely on family caregiver support. We identify whether and which caregiver characteristics are associated with older adults’ ED use. Methods: We use Cox proportional hazards regression to model the likelihood of all-cause ED use (defined as 1 or more visits within 12 months of survey) as a function of caregiver characteristics after adjusting for older adult sociodemographic and health characteristics. We draw from linked older adult and caregiver surveys and administrative claims, creating a sample of 2521 community-living older adults with mobility/self-care disability receiving care from a family or unpaid caregiver. Results: About half (52.5%) of older adults receiving mobility or self-care help incurred 1 or more ED visits within 12 months of interview. Adjusting for year of data collection, sociodemographic characteristics, and health status, these older adults were at greater risk of all-cause ED use if their primary caregiver provided greater than 40 hours of care per week (hazard ratio [HR] 1.22, 95% CI 1.04-1.43; P = .02), helped with health care tasks (HR 1.26; 95% CI 1.08-1.46; P < .01), or experienced physical strain (HR 1.18; 95% CI 1.03-1.36; P = .02). Conclusion: Caregiver strain, helping with health care tasks, and greater hours of help per week are associated with heightened risk of ED use among older adults receiving mobility or self-care help. Study findings suggest the potential benefit of caregiver assessment and support.
format Online
Article
Text
id pubmed-6764037
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-67640372019-10-09 Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities Burgdorf, Julia Mulcahy, John Amjad, Halima Kasper, Judith D. Covinsky, Kenneth Wolff, Jennifer L. J Prim Care Community Health Original Research Background: Older adults with disability are frequent users of the emergency department (ED) and often rely on family caregiver support. We identify whether and which caregiver characteristics are associated with older adults’ ED use. Methods: We use Cox proportional hazards regression to model the likelihood of all-cause ED use (defined as 1 or more visits within 12 months of survey) as a function of caregiver characteristics after adjusting for older adult sociodemographic and health characteristics. We draw from linked older adult and caregiver surveys and administrative claims, creating a sample of 2521 community-living older adults with mobility/self-care disability receiving care from a family or unpaid caregiver. Results: About half (52.5%) of older adults receiving mobility or self-care help incurred 1 or more ED visits within 12 months of interview. Adjusting for year of data collection, sociodemographic characteristics, and health status, these older adults were at greater risk of all-cause ED use if their primary caregiver provided greater than 40 hours of care per week (hazard ratio [HR] 1.22, 95% CI 1.04-1.43; P = .02), helped with health care tasks (HR 1.26; 95% CI 1.08-1.46; P < .01), or experienced physical strain (HR 1.18; 95% CI 1.03-1.36; P = .02). Conclusion: Caregiver strain, helping with health care tasks, and greater hours of help per week are associated with heightened risk of ED use among older adults receiving mobility or self-care help. Study findings suggest the potential benefit of caregiver assessment and support. SAGE Publications 2019-09-24 /pmc/articles/PMC6764037/ /pubmed/31550971 http://dx.doi.org/10.1177/2150132719875636 Text en © The Author(s) 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Burgdorf, Julia
Mulcahy, John
Amjad, Halima
Kasper, Judith D.
Covinsky, Kenneth
Wolff, Jennifer L.
Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities
title Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities
title_full Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities
title_fullStr Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities
title_full_unstemmed Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities
title_short Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities
title_sort family caregiver factors associated with emergency department utilization among community-living older adults with disabilities
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764037/
https://www.ncbi.nlm.nih.gov/pubmed/31550971
http://dx.doi.org/10.1177/2150132719875636
work_keys_str_mv AT burgdorfjulia familycaregiverfactorsassociatedwithemergencydepartmentutilizationamongcommunitylivingolderadultswithdisabilities
AT mulcahyjohn familycaregiverfactorsassociatedwithemergencydepartmentutilizationamongcommunitylivingolderadultswithdisabilities
AT amjadhalima familycaregiverfactorsassociatedwithemergencydepartmentutilizationamongcommunitylivingolderadultswithdisabilities
AT kasperjudithd familycaregiverfactorsassociatedwithemergencydepartmentutilizationamongcommunitylivingolderadultswithdisabilities
AT covinskykenneth familycaregiverfactorsassociatedwithemergencydepartmentutilizationamongcommunitylivingolderadultswithdisabilities
AT wolffjenniferl familycaregiverfactorsassociatedwithemergencydepartmentutilizationamongcommunitylivingolderadultswithdisabilities