Health care utilization among homebound elders: does caregiver burden play a role?
OBJECTIVE
To describe informal caregiver and patient characteristics associated with high caregiver burden in homebound elders and to examine associations between high caregiver burden and patient health care utilization at the practice level.


METHODS
We used a cross-sectional and prospective cohort design to study 214 caregiver-patient dyads in a home-based primary care program.


RESULTS
Informal caregivers with the highest burden were more likely to help with more activities of daily living and instrumental activities of daily living and spend >40 hr/week in caregiving. Patients whose caregivers experienced the highest burden were more likely to be non-White males without 24-hr paid homecare. There were no significant independent associations between high burden and high calls, high visits, or social work involvement.


CONCLUSIONS
In this medically complex and highly dependent population, further study of how families and other caregivers impact health care utilization is needed.
Icahn School of Medicine at Mount Sinai, New York, NY, USA. Jennifer.reckrey@mountsinai.org
Jennifer M
JM
Reckrey
Linda V
LV
Decherrie
Amy S
AS
Kelley
Katherine
K
Ornstein
D000368:Aged; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data; D006701:Home Nursing / Q000523:psychology* / Q000706:statistics & numerical data; D018577:Homebound Persons / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012947:Social Work; D013997:Time Factors
caregiving; families; geriatrics; health services; homebound