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The Use of Acute Health Care Services by Mentally-Ill Seniors of Newfoundland and Labrador: A Quantitative Investigation Open Access


Other title
Mental illness
Hospital use
Type of item
Degree grantor
University of Alberta
Author or creator
Adams, Lisa Y.
Supervisor and department
Dr. Priscilla Koop
Dr. Colleen Norris
Examining committee member and department
Dr. Wendy Duggleby (Nursing)
Dr. Jean Triscott (Medicine)
Dr. Gerry Lasiuk (Nursing)
Dr. Huda Quan (Medicine)
Dr. Joy Fraser (Health Sciences)
Faculty of Nursing

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Background The population of seniors is increasing rapidly. Currently, seniors represent 14.1% of the population of Canada and 14.4% of the population of Newfoundland and Labrador (NL), rates that are expected to further increase to 30% by 2041 and 2026, respectively. There is ongoing debate regarding whether mental illness (MI) is more or less prevalent in seniors compared with other age cohorts and whether or not they receive needed services. The purpose of this research study was to first compare the use of acute care in-patient hospital services (Length of stay (LOS), Acute LOS, ER wait time, Rate of admission (ROA), RIW and cost) of seniors with and without MI in the province of NL and explore key predictors of service use. Method This descriptive-comparative research design using aggregate population level data from the NL Center for Health Information (NLCHI) databases included all people aged 65 years and older admitted to an acute care hospital in the province of NL (12,502) with and without MI codes in 2008-2009. Dependent variables included LOS, ALOS, ROA, ER waiting time, RIW and cost. In addition, numerous other demographics and admission and discharge information were assessed. Results Results indicated that only 10% of seniors had a MI code applied to their hospital admission however, they had a significantly longer LOS, ALOS, ROA, ER wait time, RIW and cost than did seniors without MI codes. Even after controlling for co-morbidities, seniors with MI codes still used significantly more resources. Further, while female seniors with MI were greater users of services, males were more expensive to maintain in hospital. Urban seniors most often had MI codes and consumed more hospital resources compared to seniors from rural areas. Conclusion Although the overall prevalence of MI in seniors in this study was low, their use of acute hospitals and associated costs was high and even excessive at times, compared to seniors without MI codes. Further, although acute care hospitals are the main focal point to stabilize seniors with MIs, the acute environment not only jeopardizes seniors’ mental health, but their mental and physical health as well.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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