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Title: The Association of Comorbid Chronic Physical Conditions and Psychological Illness with Health Care Utilization in Middle-Aged and Older People

Citation Type: Dissertation/Thesis

Publication Year: 2017

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Abstract: The proportion of Americans that are 65 years of age and older will be about 20 percent, or a total of 84 million persons, by 2050 (Ortman, Velkoff, & Hogan, 2014). This rapidly growing population of older adults, coupled with increasing life expectancy and disease dynamics, foretell rises in the prevalence of chronic physical health illnesses. Complicating these matters is the fact that, often, chronic physical health conditions are accompanied by psychological conditions such as serious psychological distress, depression, and dementia. The high prevalence of comorbid conditions in such a large segment of the population suggests impacts on health care utilization that may threaten both the public and financial health of the United States. Although the health care utilization consequences of comorbid chronic physical illnesses and common psychological conditions are important, this specific research area has not garnered sufficient attention in aging research. Furthermore, studies have not directly examined whether associations between comorbid conditions and the utilization of health services vary by gender or racial and ethnic composition. This dissertation addresses this topic using national representative samples from the Integrated Health Interview Series conducted in 2007, 2010, 2011, 2012 and 2013. The study focuses on associations between comorbid conditions and the use of health services among middle-aged and older Americans. Two measures of health care services utilization are explored: visits to general providers and visits to mental health professionals. Results from logistic regressions suggest that serious psychological distress is more strongly associated with visits to general physicians when accompanied by chronic physical conditions. But it has a weaker association with visits to mental health providers when accompanied by chronic physical conditions. The association between serious psychological distress comorbidity and visits to general providers is stronger for all other races than for Hispanic/Latino(s). In addition, the association between serious psychological distress comorbidity and visits to mental health professionals is stronger for males than for females. However, associations between depression and visits to providers are independent of whether chronic physical conditions are also present. Similarly, associations between dementia and visits to providers are independent of whether chronic physical conditions are also present.

Url: https://search.proquest.com/docview/1986008540/abstract/C0362495BE304B3FPQ/1?accountid=14586

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Authors: Houston, Allison

Institution: State University of New York at Albany

Department: Sociology

Advisor: Glenna D. Spitze

Degree: Doctor of Philosophy

Publisher Location: Albany, NY

Pages: 325

Data Collections: IPUMS Health Surveys - NHIS

Topics: Aging and Retirement, Gender, Health, Population Health and Health Systems, Race and Ethnicity

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