Multi-Morbid Health Profiles and Specialty Healthcare Service Use: A Moderating Role of Poverty.

Ilan Kwon,Oejin Shin,Sojung Park,Goeun Kwon

doi:10.3390/ijerph16111956

Abstract

Increasing life expectancy in the USA makes a better understanding of the heterogeneous healthcare needs of the aging population imperative. Many aging studies have discovered multimorbid health problems focusing mainly on various physical health conditions, but not on combined mental or behavioral health problems. There is also a paucity of studies with older adults who use professional healthcare services caring for their mental and substance-related conditions. This study aims to enhance the knowledge of older peoples’ complex healthcare needs involving physical, mental, and behavioral conditions; examine the relationship between multi-morbid health profiles and specialty healthcare service utilization; and investigate its association to poverty. The study data were derived from the National Survey on Drug Use and Health (NSDUH) in 2013 (n = 6296 respondents aged 50 years and older). To identify overall health conditions, nine indicators, including physical, mental, and substance/alcohol, were included. Healthcare service utilization was measured with four mutually exclusive categories: No treatment, mental health treatment only, substance use treatment only, and both. We identified four health profiles: Healthy (82%), having physical health problems (6%), physical and mental health problems (4%), and behavioral problems (8%). Older people’s health profiles were differentially associated with healthcare use. Those living in poverty with both physical and mental health problems or substance/alcohol health problems were less likely to receive mental health and substance use treatments than those with more financial resources. Implications for geriatric healthcare practices and policy are discussed.

Highlights

Older people comprise about 13% of the US population, they accounted for 34% of healthcare-related spending in 2010 [1]
Many studies on multi-morbidity tend to focus on physical health conditions, such as high cholesterol, high blood
After dropping all missing values, a total of 6325 responses was used for running latent clustering analyses (LCA) with nine health indicators, 6294 for conducting multinomial logistic regression to examine the characteristics of each health profile group, and 6278 for examining the relationships among the health profiles, poverty, and specialty healthcare service use

Summary

Introduction

Older people comprise about 13% of the US population, they accounted for 34% of healthcare-related spending in 2010 [1]. One-third of the middle-aged (between 45 and 65 years) and about two-thirds of the older age group (61% of people aged 65 years or more) reported having more than two health conditions [3]; the prevalence of multi-morbidity in the older population has increased from 55.4% in 2002 to 61.6% in 2015 [4]. To provide cost- and outcome-effective healthcare services, a primary task is to make an accurate diagnosis of older individuals with multiple healthcare needs. Many studies on multi-morbidity tend to focus on physical health conditions, such as high cholesterol, high blood. Public Health 2019, 16, 1956; doi:10.3390/ijerph16111956 www.mdpi.com/journal/ijerph

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