Service Utilization among Older Schizophrenic Persons

Long Island University Brooklyn Campus, Brooklyn NY

Investigators

Linked publications & trials

Abstract

Although the number of older persons (age 55+) with schizophrenia will double over the next 25 years, there[unreadable] has been little research on service utilization and its adequacy in this population. Before embarking on costly[unreadable] intervention projects, it would seem logical to perform prospective naturalistic studies of existing programs.[unreadable] The principal goal of this study is to examine those factors that affect service use and its perceived adequacy.[unreadable] We will use a theoretical model that was developed in earlier studies with this population. We will test 2[unreadable] broad hypotheses: 1) The theoretical model will significantly explain various types of service use and their[unreadable] adequacy; 2) Each of the variable sets in the model will account for significant variance in the types of service[unreadable] use and their adequacy. We will conduct a 32-month follow-up evaluation of schizophrenic persons who had[unreadable] been interviewed in a 2-year grant funded by NIGMS during 2001-2003. We will add 70 new subjects to[unreadable] bring the Time 1 total to 270. We estimate that at least 200 subjects will complete the Time 2 interviews.[unreadable] Subjects will consist of community-dwelling persons aged 55 and over with a DSM-IV diagnosis of[unreadable] schizophrenia and schizoaffective disorder who developed the disorder before age 45, and who are living[unreadable] independently or in residential programs. In our initial study, we also developed a baseline comparison[unreadable] group of older community persons (n= 204). We will use hierarchical regression, path analysis, and structural[unreadable] equation modeling for the data analyses. This study is unique in that it utilizes service data from the Centers[unreadable] for Medicare and Medicaid Services to complement self-reports of service use; that it has a high proportion of[unreadable] African Americans (34%); and that it employs a theoretical model that can examine the flux and interplay of[unreadable] variables and allow for the generalization of the results. Thus, the results of this study will allow for more[unreadable] rationale decisions about interventions and identify factors that need to be controlled or taken into account in[unreadable] outcome analyses. Finally, at the conclusion of this study, we will have developed a 2nd national site for[unreadable] studying older schizophrenic persons that is more traditionally urban and has proportionately more African[unreadable] Americans than the San Diego site. This will be a 3-year study.