Chu Jun, Mair Christine A, Yamashita Takashi, Chen Jie
Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, MD, USA.
Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, USA.
J Appl Gerontol. 2025 Feb 26:7334648251323022. doi: 10.1177/07334648251323022.
Older adults suffering from serious psychological distress (SPD) have higher health care utilization and expenditures. However, it is unknown whether living alone might further amplify differences in health care usage and costs among older adults with SPD. Using pooled data from 2007-2019 Medical Expenditure Panel Survey, we estimated the incremental care expenditures and utilization associated with SPD among older adults living alone and living with others. The results show that in both living arrangements, having SPD is associated with increases in emergency department visits, hospital admissions, and prescription fill-ups, which leads to higher total prescription expenditures. However, the incremental differences of SPD-related incremental usage and expenditures between older adults living alone and living with others were similar. Our findings call for targeted community programs for older adults that go beyond eliminating physical loneliness, and innovative care coordination strategies that prioritize mental health and preventative care among older adults.
患有严重心理困扰（SPD）的老年人医疗保健利用率和支出更高。然而，独居是否会进一步扩大患有SPD的老年人在医疗保健使用和成本方面的差异尚不清楚。利用2007 - 2019年医疗支出面板调查的汇总数据，我们估计了独居和与他人同住的老年人中与SPD相关的增量护理支出和利用率。结果表明，在两种居住安排中，患有SPD都与急诊就诊、住院和处方配药的增加有关，这导致总处方支出更高。然而，独居和与他人同住的老年人之间与SPD相关的增量使用和支出的差异相似。我们的研究结果呼吁针对老年人制定有针对性的社区项目，这些项目不仅仅是消除身体上的孤独，还需要创新的护理协调策略，将老年人的心理健康和预防保健放在首位。
