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

• Author / Creator

  Adams, Lisa Y.

• 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.

• Subjects / Keywords

  • Seniors
  • Mental illness
  • Hospital use

• Graduation date

  Spring 2012

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R30H2S

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.