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Cognitive function and acute care utilization.

Publication ,  Journal Article
Walsh, EG; Wu, B; Mitchell, JB; Berkmann, LF
Published in: The journals of gerontology. Series B, Psychological sciences and social sciences
January 2003

OBJECTIVES: Little is known about variation in cognitive function across the aged population, or how use and costs of health care vary with cognitive impairment. This study was designed to create a typology of cognitive function in a nationally representative sample, and evaluate acute care use in relation to cognitive function, holding constant confounding factors. By including proxy assessments of cognitive function, this is the first study to include individuals unable to respond themselves. METHODS: We analyzed the baseline year of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, sponsored by the National Institute on Aging, to create three levels of cognitive function, using direct measures for self-respondents (n = 6,651) and proxy evaluations for the others (n = 792). We used a two-part model to predict the likelihood of using various health services and to evaluate intensity of care among users. RESULTS: Sixteen percent, 64\%, and 20\% of the sample fell into the low, moderate, and high cognitive function groups, respectively, that differed significantly on almost all demographic and health status measures, and some utilization measures. Controlling for other health and functional status measures, lower cognitive function had a significant and negative effect on outpatient services, but did not affect hospital use directly. DISCUSSION: Lower cognitive function may be a barrier to outpatient care, but these analyses should be repeated using administrative use and cost data.

Duke Scholars

Published In

The journals of gerontology. Series B, Psychological sciences and social sciences

ISSN

1079-5014

Publication Date

January 2003

Volume

58

Issue

1

Start / End Page

S38 / S49

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Outpatient Clinics, Hospital
  • Neuropsychological Tests
  • Male
  • Length of Stay
  • Humans
  • Hospitals
  • Hospitalization
  • Health Status
 

Citation

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Walsh, E. G., Wu, B., Mitchell, J. B., & Berkmann, L. F. (2003). Cognitive function and acute care utilization. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 58(1), S38–S49.
Walsh, E. G., B. Wu, J. B. Mitchell, and L. F. Berkmann. “Cognitive function and acute care utilization.The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 58, no. 1 (January 2003): S38–49.
Walsh EG, Wu B, Mitchell JB, Berkmann LF. Cognitive function and acute care utilization. The journals of gerontology Series B, Psychological sciences and social sciences. 2003 Jan;58(1):S38–49.
Walsh, E. G., et al. “Cognitive function and acute care utilization.The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, vol. 58, no. 1, Jan. 2003, pp. S38–49.
Walsh EG, Wu B, Mitchell JB, Berkmann LF. Cognitive function and acute care utilization. The journals of gerontology Series B, Psychological sciences and social sciences. 2003 Jan;58(1):S38–S49.
Journal cover image

Published In

The journals of gerontology. Series B, Psychological sciences and social sciences

ISSN

1079-5014

Publication Date

January 2003

Volume

58

Issue

1

Start / End Page

S38 / S49

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Outpatient Clinics, Hospital
  • Neuropsychological Tests
  • Male
  • Length of Stay
  • Humans
  • Hospitals
  • Hospitalization
  • Health Status