title: Living alone and outpatient care use by older veterans.
abstract: In nonveteran older adults, living alone influences outpatient care use, but its importance in the veteran population has not been well studied. The aims of this study are to describe the use of outpatient care by older veterans who live alone versus those who live with others and determine whether living alone influences outpatient use by older veterans. The data come from the 2001 Veteran Identity Program Survey designed to measure Department of Veterans Affairs (VA) and non-VA outpatient care use. Univariate and bivariate analyses were conducted to examine distributional properties, associations, and subgroup differences in outpatient care use. Poisson regression was used to assess the role of living alone on outpatient care use, controlling for predisposing, other enabling, and need factors. Results found that older veterans who use the VA, whether they live alone or not, have similar numbers of VA outpatient visits. Older veterans who use VA and non-VA facilities and who live alone have greater total outpatient visits than those who live with others. Regression results indicate that living alone is a predictor of VA routine medical visits, VA prescription refill visits, and total VA and non-VA outpatient visits but does not influence VA emergency room visits. These findings suggest that living alone is associated with differences in outpatient care use by older veterans. It is important for the VA to understand this relationship with the aim of developing interventions to improve access, effectiveness, and efficiency of health services for older veterans.
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, and School of Nursing, University of Califorinia at Los Angeles, 90073, USA. jenice.guzman@med.va.gov
authors.forename: Jenice S
authors.initials: JS
authors.lastname: Guzman
authors.forename: Linda
authors.initials: L
authors.lastname: Sohn
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Harada
mesh_terms: D000203:Activities of Daily Living; D000368:Aged / Q000523:psychology / Q000706:statistics & numerical data; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D015984:Causality; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D015577:Geriatric Assessment; D015438:Health Behavior; D019538:Health Care Surveys; D006302:Health Services Research; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D016012:Poisson Distribution; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data