Reporting mistreatment of older adults: the role of physicians

Abstract

Objective: To characterize elder mistreatment reporting patterns over time and by reporting source with specific focus on physician reporting. To determine whether demographic or socioeconomic factors influenced the reporting of elder abuse in Michigan between 1989 and 1993 and whether these factors affected physician reporting rates.

Design: Analysis of the State of Michigan's records of reported cases of suspected adult abuse for the years 1989-1993.

Measurements: Counties were categorized by size, urbanization, and average income. The study population was analyzed as four age groups: 18-64, 65-74, 75-84, and 85-99. Physician to population ratios were calculated for the county types and compared with physician reporting rates.

Main results: A total of 27,371 cases of possible abuse were reported, 17,238 in persons older than age 65. Physicians reported only 2% of cases, and physician reporting rates did not increase over the 5-year period. Physician reporting rates were highest in small counties with low physician to population ratios. There was a high percentage of primary care physicians in these counties. Forty-seven percent of all reported cases were substantiated. There was no difference in substantiation rate for physician-reported cases compared with other professional reporting sources.

Conclusion: Physician reports average only 2% of all reports of suspected elder mistreatment. Primary care physicians in counties with low physician to population ratios appear to be more active in reporting mistreatment of older people. Increasing physician awareness of the problem of elder mistreatment and providing physicians with the tools to screen for mistreatment should increase the number of cases that are reported to the agencies responsible for assisting mistreated older people.