This paper determines whether elderly women have more or less utilization of hospital critical care services and case management support than elderly men, and whether these women have differential health outcomes than men controlling for clinical risk factors and delivery system changes. Medical record data was collected for approximately 200 patients discharged during 1995-1997 from a large regional hospital. Data include detailed information concerning diagnostic patterns, treatment chronology, consultations, post-discharge planning services, readmission status, and one-year mortality that are not available on statewide public use files. Qualitative information was also gathered concerning patients’ social support network, and provider perceptions of care delivery that could affect outcomes. Regression models were used to predict the likelihood of hospital and one-year survival for these patients, as well as the likelihood of skilled nursing facility (SNF) admissions among survivors. Results show that although women do not have differential hospital survival than men, they have less case management support and are more likely to be discharged to SNFs due to lack of social support. This information gives identifies the roles of patient selection and practice pattern variations on patient outcomes as the hospital system’s resources become more restricted. These findings can be used to identify policies that can improve access to care and the associated health outcomes for the frail elderly – particularly elderly women who have fewer social supports and less financial access to acute care and post-acute services.
Learning Objectives: Participants will be able to identify practices that can improve access to care and the associated health outcomes for frail elderly women.
Keywords: Elderly, Women's Health
Awards: best paper on "older women and public health" - Honorable MentionPresenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.