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- Title
Psychopathology and emotional distress among older high-utilizing health maintenance organization patients.
- Authors
Haas LJ; Spendlove DC; Silver MP; Holmberg TC; Haas, L J; Spendlove, D C; Silver, M P; Holmberg, T C
- Abstract
<bold>Background: </bold>Rates of psychopathology are often underestimated in primary care populations, especially older patient groups. High medical utilization is often a reflection of psychopathology and/or emotional distress. Increased awareness of primary care patients' emotional distress can help to improve well-being and reduce unnecessary high utilization of medical services. This study aimed to assess the degree of psychopathology present in a sample of older health maintenance organization (HMO) patients who utilized higher-than-average amounts of medical services.<bold>Methods: </bold>Patients in a large HMO aged 55 years old and older who exceeded the mean number of inpatient and outpatient visits in the past year were recruited. Sixty-nine patients, mostly female (69%) and white (93%), volunteered. Patients were assessed with the Medical Outcomes Study SF-36 health survey and the Symptom Checklist-90-Revised (SCL-90-R).<bold>Results: </bold>Respondents made a mean of 41 visits in the previous year to medical providers, versus 24 visits per year for the average patient of this age in the HMO. Significant elevations on SCL-90-R global psychopathology, obsessive-compulsive, somatization, and depression scales were found. All patients met SCL-90-R criteria for psychiatric caseness. SF-36 health ratings were comparable with those of patients with chronic medical conditions assessed in other SF-36 samples.<bold>Conclusions: </bold>Older high-utilizing HMO patients show significantly more psychopathology and view their health status as poorer than that of other medical subpopulations; results suggest that care for these problems is rarely received.
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 1999, Vol 54, Issue 11, pM577
- ISSN
1079-5006
- Publication type
journal article
- DOI
10.1093/gerona/54.11.m577