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The effect of living alone on the costs and benefits of surgery amongst older people

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  • Turner, Alex J.
  • Nikolova, Silviya
  • Sutton, Matt

Abstract

Older people who live alone are a growing, high-cost group for health and social services. The literature on how living alone affects health and the costs and benefits of healthcare has focused on crude measures of health and utilisation and gives little consideration to other cost determinants and aspects of patient experience. We study the effect of living alone at each stage along an entire treatment pathway using a large dataset which provides information on pre-treatment experience, treatment benefits and costs of surgery for 105,843 patients receiving elective hip and knee replacements in England in 2009 and 2010. We find that patients who live alone are healthier prior to treatment and experience the same gains from treatment. However, living alone is associated with a 9.2% longer length of in-hospital stay and increased probabilities of readmission and discharge to expensive destinations. These increase the costs per patient by £179.88 (3.12%) and amount to an additional £4.9 million per annum. A lack of post-discharge support for those living alone is likely to be a key driver of these additional costs.

Suggested Citation

  • Turner, Alex J. & Nikolova, Silviya & Sutton, Matt, 2016. "The effect of living alone on the costs and benefits of surgery amongst older people," Social Science & Medicine, Elsevier, vol. 150(C), pages 95-103.
  • Handle: RePEc:eee:socmed:v:150:y:2016:i:c:p:95-103
    DOI: 10.1016/j.socscimed.2015.11.053
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    References listed on IDEAS

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    1. Laporte, Audrey & Nauenberg, Eric & Shen, Leilei, 2008. "Aging, social capital, and health care utilization in Canada," Health Economics, Policy and Law, Cambridge University Press, vol. 3(4), pages 393-411, October.
    2. Rachel Meacock & Søren Rud Kristensen & Matt Sutton, 2014. "The Cost‐Effectiveness Of Using Financial Incentives To Improve Provider Quality: A Framework And Application," Health Economics, John Wiley & Sons, Ltd., vol. 23(1), pages 1-13, January.
    3. John Antonakis & Samuel Bendahan & Philippe Jacquart & Rafael Lalive, 2010. "On making causal claims : A review and recommendations," Post-Print hal-02313119, HAL.
    4. Kilpi, Fanny & Konttinen, Hanna & Silventoinen, Karri & Martikainen, Pekka, 2015. "Living arrangements as determinants of myocardial infarction incidence and survival: A prospective register study of over 300,000 Finnish men and women," Social Science & Medicine, Elsevier, vol. 133(C), pages 93-100.
    5. Rose, Richard, 2000. "How much does social capital add to individual health?A survey study of Russians," Social Science & Medicine, Elsevier, vol. 51(9), pages 1421-1435, November.
    6. Davis, M.A. & Moritz, D.J. & Neuhaus, J.M. & Barclay, J.D. & Gee, L., 1997. "Living arrangements, changes in living arrangements, and survival among community dwelling older adults," American Journal of Public Health, American Public Health Association, vol. 87(3), pages 371-377.
    7. Li, Lydia W. & Zhang, Jiaan & Liang, Jersey, 2009. "Health among the oldest-old in China: Which living arrangements make a difference?," Social Science & Medicine, Elsevier, vol. 68(2), pages 220-227, January.
    8. Manuel Gomes & Nils Gutacker & Chris Bojke & Andrew Street, 2014. "Addressing missing data in patient-reported outcome measures (PROMs): implications for comparing provider performance," Working Papers 101cherp, Centre for Health Economics, University of York.
    9. A. Walter-Ginzburg & T. Blumstein & A. Chetrit & B. Modan, 2002. "Social Factors and Mortality in the Old-Old in Israel," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 57(5), pages 308-318.
    10. Boukje Maria van Gelder & Marja Tijhuis & Sandra Kalmijn & Simona Giampaoli & Aulikki Nissinen & Daan Kromhout, 2006. "Marital Status and Living Situation During a 5-Year Period Are Associated With a Subsequent 10-Year Cognitive Decline in Older Men: The FINE Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 61(4), pages 213-219.
    11. Lund, Rikke & Due, Pernille & Modvig, Jens & Holstein, Bjørn Evald & Damsgaard, Mogens Trab & Andersen, Per Kragh, 2002. "Cohabitation and marital status as predictors of mortality--an eight year follow-up study," Social Science & Medicine, Elsevier, vol. 55(4), pages 673-679, August.
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