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

BMC Geriatr. 2018 Dec 5;18(1):269. doi: 10.1186/s12877-018-0939-4.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Emergency care; General practice; Household; Inpatient care; Older; Utilisation.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Electronic Health Records
  • Female
  • General Practice* / organization & administration
  • Health Care Surveys
  • Humans
  • London / epidemiology
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Quality of Life
  • Residence Characteristics / statistics & numerical data*
  • Retrospective Studies