Patient experience with healthcare services among older adults with serious mental illness compared to the general older population

Author:

Fortuna Karen L123,Lohman Matthew C123,Batsis John A12456,DiNapoli Elizabeth A78,DiMilia Peter R15,Bruce Martha L356,Bartels Stephen J1236

Affiliation:

1. Dartmouth Centers for Health and Aging, Lebanon, NH, USA

2. CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, USA

3. Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA

4. General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

5. The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, USA

6. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

7. VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, PA, USA

8. Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA

Abstract

Objective To compare patient experience with healthcare services and providers among older patients (≥50 years old) with and without serious mental illness. Methods Using secondary data from the Medical Expenditures Panel Survey from 2003 through 2013, we compared adults aged 50 years and older with schizophrenia spectrum disorder ( n = 106), mood disorders (i.e., major depressive disorder and bipolar disorder) ( n = 419), and no serious mental illness ( n = 34,921). Results Older adults with schizophrenia spectrum disorder reported significantly worse provider communication than older adults without serious mental illness. Older adults with mood disorders reported the greatest barriers to shared decision-making and the greatest difficulty accessing services. Conclusions Our results highlight the need to improve the patient experience of older adults with serious mental illness. Addressing provider communication, shared decision-making, and access to care among this vulnerable group of older adults may impact clinical outcomes and costs. Future research examining the extent to which improving the patient experience may improve health outcomes and enhance treatment for this highly vulnerable older group is warranted.

Funder

National Institute of Mental Health

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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