To improve health care for the elderly, a consideration of biopsychosocial health care needs may be of particular importance—especially because of the prevalence of multiple conditions, mental disorders, and social challenges facing elderly people. The aim of the study was to investigate significance and costs of biopsychosocial health care needs in elderly people.
Data were derived from the 8-year follow-up of the ESTHER study—a German epidemiological study in the elderly population. A total of 3124 participants aged 57 to 84 years were visited at home by trained medical doctors. Biopsychosocial health care needs were assessed using the INTERMED for the Elderly (IM-E) interview. Health-related quality of life (HRQOL) was measured by the 12-Item Short-Form Health Survey, and psychosomatic burden was measured by the Patient Health Questionnaire.
The IM-E correlated with decreased mental (mental component score: r = −0.38, p < .0001) and physical HRQOL (physical component score: r = −0.45, p < .0001), increased depression severity (r = 0.53, p < .0001), and costs (R = 0.41, p < .0001). The proportion of the participants who had an IM-E score of at least 21 was 8.2%; according to previous studies, they were classified as complex patients (having complex biopsychosocial health care needs). Complex patients showed a highly reduced HRQOL compared with participants without complex health care needs (mental component score: 37.0 [10.8] versus 48.7 [8.8]; physical component score: 33.0 [9.1] versus 41.6 [9.5]). Mean health care costs per 3 months of complex patients were strongly increased (1651.1 € [3192.2] versus 764.5 € [1868.4]).
Complex biopsychosocial health care needs are strongly associated with adverse health outcomes in elderly people. It should be evaluated if interdisciplinary treatment plans would improve the health outcomes for complex patients.
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From the Department of General Internal Medicine and Psychosomatics (B.W., I.M., D.N., W.H.), Medical University Hospital, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research (K.-U.S., H.B.), German Cancer Research Center, Heidelberg, Germany; Departments of Internal Medicine and Geriatrics (J.S.), University Hospital, Groningen, the Netherlands; Department of Psychosomatics and Psychotherapy (W.S.), General Hospital, Nürnberg, Germany; and Department of Health Economics and Health Services Research (D.H., H.-H.K.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Address correspondence and reprint requests to Beate Wild, PhD, Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. E-mail: firstname.lastname@example.org
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Received for publication October 5, 2013; revision received May 1, 2014.