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Age and Ageing 2002; 31: 445-450
© 2002, British Geriatrics Society

Research paper

Slicing the health service cake: the Islington study

Tanya Nelson, Gill Livingston, Martin Knapp1, Monica Manela, Ginnette Kitchen and Cornelius Katona

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Archway campus, Holborn Union Building, Highgate Hill, London N19 5NF, UK
1 Pssru, London School of Economics and Political Science, and Centre for the Economics of Mental Health, Institute of Psychiatry, London, UK

Abstract

Background: little is known about the factors that are associated with receipt of care in older people. This study aims to describe the pattern and predictors of service usage, by a representative sample of people aged 65 and over.

Method: we assessed psychiatric and physical morbidity, formal and informal care and prescribed medication by standardized questionnaires.

Results: 1085 people were interviewed at home. Having dementia was a negative predictor of GP and hospital consultation (both P<0.001). Depressed participants were most likely to consult with GPs (P<0.05); 13.1% were on antidepressants. People with dementia use health services less than their counterparts. The presence of co-resident informal caregivers predicts less use of social services but no increase in health consultations.

Conclusions: carers give compensatory care rather than act as bridges to link people with dementia with the health care system. People with dementia need advocates. Older people with depression are high users of all services. They remain under-treated pharmacologically.

Keywords: dementia, depression, formal and informal care, service usage


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E. L. Sampson, M. R. Blanchard, L. Jones, A. Tookman, and M. King
Dementia in the acute hospital: prospective cohort study of prevalence and mortality
The British Journal of Psychiatry, July 1, 2009; 195(1): 61 - 66.
[Abstract] [Full Text] [PDF]


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