Management Brief uHealth Services Research & Development Service uNo.5, October, 2002 

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MANAGEMENT BRIEF provides VA senior management with a timely and concise 

summary of an important HSR&D finding or publication.

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(Please forward this information to other interested parties) 

Aging and schizophrenia

Results are in on one of the first large-scale studies (102,256 adults) to examine 

the use of medical services and psychiatric services by older persons with schizophrenia, 

as well as their level of functioning. Investigators studied three age groups (18-44, 45-

59, and 60+), examining the relationship between age group, health care utilization, and 

functioning. Data on utilization was obtained from the VA National Psychosis Registry. 

Findings show that older adults experienced fewer psychiatric hospitalizations but, when 

hospitalized had longer stays (averaging 71 days yearly versus 30 days for younger 

adults). Additionally, older patients had fewer psychiatric outpatient visits than younger 

patients (averaging 20 visits compared to 29). Not surprisingly, older patients had both 

more medical outpatient visits and more medical hospitalizations than the younger group 

because they have more comorbid medical conditions, such as hypertension, diabetes, 

and heart disease. However, the relatively lower use of outpatient psychiatric care by 

older patients suggests that there may be barriers to accessing these services. This could 

be because older patients are more likely to be in nursing homes where they may receive 

less psychiatric care in general, and may be unlikely to receive structured outpatient care. 

With less regular follow-up, clinicians may be less likely to recognize symptoms of 

relapse among these patients and to intervene so that hospitalization might be avoided. 

The number of people with schizophrenia who are older than 55 is increasing 

rapidly, and health costs associated with the treatment of older patients with this disorder 

are significantly greater. Thus, developing efficient, accessible services for them is very 

important. In addition, understanding the utilization patterns of older patients with 

schizophrenia will inform health care planners and policy makers who must make 

decisions about resource allocation and program development. 

Barry KL, Blow FC, Dornfeld M, Valenstein M. Aging and schizophrenia: current health 

services research and recommendations. Journal of Geriatric Psychology and Neurology 2002 

Fall;15(3):121-7. 

This study was conducted by several HSR&D investigators and was funded through VA’s Serious 

Mental Illness Treatment Research and Evaluation Center (SMITREC), housed within HSR&D’s 

Center for Practice Management and Outcomes Research, in Ann Arbor, MI.
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