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  5. Primary Care Utilization Among Legally Adjudicated Elder Mistreatment Cases in Comparison to Other Older Adults

Primary Care Utilization Among Legally Adjudicated Elder Mistreatment Cases in Comparison to Other Older Adults

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File(s)
41919448.pdf (502.34 KB)
No Access Until
2027-04-01
Permanent Link(s)
https://hdl.handle.net/1813/126861
Collections
Department of Emergency Medicine
Author
Yu, Jiani
Zhang, Hao
Wu, Yiyuan
Wen, Katherine
Strobel, Stephenson
Elman, Alyssa
Jeng, Philip
Baek, Daniel
Zhang, Yiye
Gassoumis, Zach
Bao, Yuhua
Pillemer, Karl
Rosen, Tony
Abstract

BACKGROUND: Elder mistreatment is associated with adverse health outcomes and increased Emergency Department (ED) and hospital utilization patterns in the period surrounding initial mistreatment identification. Less is known about outpatient primary care utilization, but it has been hypothesized that elder mistreatment victims may use this care less frequently than other older adults due to isolation and poor connection to outpatient providers. METHODS: We used multiple measures of outpatient primary utilization patterns including fractured care (continuity of care index (COCI) and usual provider of care (UPC) index) in the 360 days before and after mistreatment identification. Data were adjusted using US Centers for Medicare and Medicaid Services Hierarchical Condition Categories risk scores. RESULTS: This study included 114 cases and 410 controls. Median age was 72 years (IQR, 68-78 years), and 340 (64.9%) were women. During the 720 days surrounding mistreatment identification, case were more likely to have had at least one outpatient primary care visit (adjusted odds ratio [AOR], 2.05 [95% CI, 1.12-3.73]; p = 0.02) and visits to multiple primary care providers (AOR, 1.51 [95% CI, 0.99-2.29]; p = 0.05). In unadjusted and adjusted models, both COCI and UPC were significantly lower in cases than controls during the 360 days prior to identification but not in the 360 days post-identification or when examining the entire 720 days. More cases received both outpatient primary care and ED/hospital care during the 720 days (58.8% vs. 33.7%; p < 0.001). CONCLUSION: Contrary to hypotheses, older adults experiencing mistreatment were not less likely to use outpatient primary care than other older adults during the period surrounding mistreatment. Additional research is needed to examine potential explanations and explore opportunities to improve detection and intervention in primary care.

Journal / Series
Journal of the American Geriatrics Society
Volume & Issue
74(7)
Date Issued
2026-04-01
Publisher
Wiley
Keywords
WCM Library Coordinated Deposit
•
Humans
•
Aged
•
Female
•
Male
•
Elder Abuse/statistics & numerical data/legislation & jurisprudence
•
Primary Health Care/statistics & numerical data
•
United States
•
Emergency Room Visits
•
Aged, 80 and over
•
Emergency Service, Hospital/statistics & numerical data
•
Patient Acceptance of Health Care/statistics & numerical data
•
elder abuse
•
elder mistreatment
•
primary care
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primary care utilization
Related DOI
https://doi.org/10.1111/jgs.70396
Previously Published as
Yu J, Zhang H, Wu Y, Wen K, Strobel S, Elman A, Jeng P, Baek D, Zhang Y, Gassoumis Z, Bao Y, Pillemer K, Rosen T. Primary Care Utilization Among Legally Adjudicated Elder Mistreatment Cases in Comparison to Other Older Adults. Journal of the American Geriatrics Society. 2026;74(7):1892-1900. doi: 10.1111/jgs.70396. PMID: 41919448.
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
Rights URI
https://creativecommons.org/licenses/by-nc-nd/4.0/
Type
article

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