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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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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 |
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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 |
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