The association between living alone and health care utilisation in older adults: a retrospective cohort study of electronic health records from a London general practice

• Published in: BMC geriatrics 2018-12, Vol.18 (1), p.269-269, Article 269
• Main Authors: Dreyer, Kathryn, Steventon, Adam, Fisher, Rebecca, Deeny, Sarah R
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Analysis; Censuses; Cohort analysis; Demography; Elderly; Electronic Health Records; Electronic medical records; Emergency care; Emergency medical care; Female; General practice; General Practice - organization & administration; Geriatrics; Health aspects; Health care; Health Care Surveys; Health services utilization; Household; Households; Humans; Inpatient care; London - epidemiology; Male; Management; Older; Older people; Patient Acceptance of Health Care - statistics & numerical data; Patient care; Patients; Population; Public health; Quality of Life; Residence Characteristics - statistics & numerical data; Retrospective Studies; Social support; Utilisation
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-018-0939-4

In 2016, one in three older people in the UK were living alone. These patients often have complex health needs and require additional clinical and non-clinical support. This study aimed to analyse the association between living alone and health care utilisation in older patients. We conducted a retrospective cohort study of 1447 patients over the age of 64, living in 1275 households who were registered at a large general practice in South East London. The utilisation of four different types of health care provision were examined in order to explore the impact of older patients living alone on health care utilisation. After adjusting for patient demographics and clinical characteristics, living alone was significantly associated with a higher probability of utilising emergency department and general practitioner services, with odds ratios of 1.50 (95% confidence interval [CI] 1.16 to 1.93) and 1.40 (95% CI 1.04 to 1.88) respectively. Living alone has an impact on health care service utilisation for older patients. We show that general practice data can be used to identify older patients who are living alone, and general practitioners are in a unique position to identify those who could benefit from additional clinical and non-clinical support. Further research is needed to understand the mechanism driving higher utilisation for those patients who live alone.