(SDAS) Impact of Major Disorders on the Health Services Use of Family Members
Project Number: R40 MC 08722-01 Project Date: 9/1/2007 Grantee: Johns Hopkins University Department/Center: Bloomberg School of Public Health/PFRH
Final Report
Pending
Principal Investigator
Anne Riley PhD, Associate Professor, Johns Hopkins University Bloomberg School of Public Health/PFRH, 615 N. Wolfe St. Baltimore, MD 21205-2103 ariley@jhsph.edu
Abstract
The Impact of Major Disorders on the Health Services Use of the Family is a secondary data analysis study (SDAS) designed to test the hypothesis that presence of a major medical or psychiatric condition or injury in one family member increases the likelihood of and intensity of health services use in other members of the family household. If the proposed hypotheses are supported, this work will provide an improved basis for a family-centered system of medical and mental health care, for understanding the value and cost effectiveness of health services, and for the design of policies and other interventions that target the health of people who live in a family with children at home. Support of these hypotheses will also foster the development of family-level conceptual and analytic models, including a model of family health-related quality of life.
The proposed project will employ data on more than 200,000 families in the nine two-year panels of the Medical Expenditure Panel Survey (MEPS) available from its inception in 1996 through 2004. This unique nationally representative dataset provides a rich source of data including the relationship of people living in each sampled household and the health services use, expenditures, and medical and psychiatric conditions and injuries of each person in the household. The investigators have substantial experience in working with this dataset and investigating the effects of disorders on other family members.
The proposed study will test the hypothesis that the medical and psychiatric conditions and injuries of one family member influence the health services use of all members of the family. It is likely that the extent of this effect will vary based on the type of disorder, and whether it is the mother, father, or a child who has the disorder. The strategy undertaken here is to investigate the presence, extent, and pervasiveness of this family impact of disorder by examining the health services use of all family members when a major condition is present in the mother, or the father, or a child.
The overall hypothesis is that when any family member has a major medical or psychiatric condition or sustains a major injury, the health services use of all family members will increase such that these families will have significantly higher levels of all types of medical and mental health services. Specifically we expect that in families in which someone has a major condition the average health services use of family members without any major disorder will be higher than that of people in similar families in which no family member has a major medical or psychiatric condition or injury.
The proposed project addresses the critical priorities of the Maternal and Child Health Bureau by 1) strengthening the knowledge base for promoting a family-centered model of care; 2) investigating the extent to which the hypothesized effects of disorder on other family members differs for families of color and thus providing a basis for reducing disparities, should they be detected; 3) strengthening the basis for improving the quality of medical, mental health and injury care by identifying the extent of needs among family members affected by disorder/injury (and different types of disorder/injury) in the family; and 4) providing a unique and powerful methodology for investigating the effects of disorder and injuries on other family members and the family as a whole.
