Abstract
BackgroundIn 2016, one in three older people in the UK were living alone. These patients often have complex health needs and require additional clinical and non-clinical support. This study aimed to analyse the association between living alone and health care utilisation in older patients.MethodsWe conducted a retrospective cohort study of 1447 patients over the age of 64, living in 1275 households who were registered at a large general practice in South East London. The utilisation of four different types of health care provision were examined in order to explore the impact of older patients living alone on health care utilisation.ResultsAfter adjusting for patient demographics and clinical characteristics, living alone was significantly associated with a higher probability of utilising emergency department and general practitioner services, with odds ratios of 1.50 (95% confidence interval [CI] 1.16 to 1.93) and 1.40 (95% CI 1.04 to 1.88) respectively.ConclusionsLiving alone has an impact on health care service utilisation for older patients. We show that general practice data can be used to identify older patients who are living alone, and general practitioners are in a unique position to identify those who could benefit from additional clinical and non-clinical support. Further research is needed to understand the mechanism driving higher utilisation for those patients who live alone.
Highlights
In 2016, one in three older people in the UK were living alone
To address the complex health needs of older people who are often living with multiple-long term conditions [4], commissioners and clinicians often attempt to identify those at highest risk of hospital admission to target with additional clinical community care and enhanced social support [5,6,7]
One household with more than five older people was excluded from the analysis
Summary
In 2016, one in three older people in the UK were living alone. These patients often have complex health needs and require additional clinical and non-clinical support. While some existing studies have shown an association between living alone, or households with only older people, and increased health care utilisation [13,14,15,16,17], other UK-based studies have not found the same effect [18, 19] Many of these studies rely on survey data or self-reported utilisation [13,14,15, 18, 19]; analyse patterns at a practice rather than at an individual patient level [16]; or focus on only one element of health care services [13, 15,16,17].
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