Improving the Health and Social Well-being of Elderly Patients by Using Primary Care to Identify and Assist Those Who Are Failing to

Claim Their Full Entitlement to Social Security Benefits.

P.Leggett1, D.Gilliland1,2,D.O’Reilly3,M.Stevenson3,E.Deeney4,N.Lynch5,S.Brown7,P.Colvin6,E.Gallagher8,K.Steele1,2 Dept General Practice QUB,Dunluce Health Centre2,Dept. Epidemiology and PublicHealthQUB3,Belleek4,Lisnaskea5,Armagh6,Health Centres, Mountsandal Practice7,Lakeland and Sperrin Trust8.

Background:Government recognises that there are those in the population who are not claiming all of the social security benefits to which they are entitled. This project was designed to measure the amount of unclaimed benefit in a sample of people over 65 years of age attending the doctor’s surgery. It also aims to measure any changes in perceived health over the course of one year in those who obtain additional benefits and compare this difference with those who do not obtain more benefits. The data collection phase is largely complete and data analysis is ongoing. We present the main findings of the project to date.

Method:Patients over 65 years of age, who were attending their General Practitioner’s surgery were recruited from a mixture of urban and rural areas across seven different practices across Northern Ireland. A nurse recorded basic demographic information and the administered a set of standard health questionnaires (GHQ12 & SP 36) to each patient. Following this a trained social work assistant performed a “benefits assessment” on each patient and where appropriate, helped patients who were under-claiming to apply for their full entitlement of social security benefits. Approximately one year later the nurses administered the same health questionnaires to the patients and further general information was recorded. Information was coded and entered into an EXEL database by a double data entry method and subsequently transferred into an SPSS file for detailed analysis

Results:734 patients were recruited across NI, 200 each from Belfast and Coleraine, 134 from Armagh and 100 each from Lisnaskea and Belleek. 565734 (77%) completed both parts of the study. The results are summarised in table 1. A total of 139/565 (24%) of people were eligible for further benefits (range 11% to 69%). Initial assessment of the data suggests that there is a trend towards under-claiming benefits in those living in rural areas, among females and in those living in houses with-out central heating. Most benefits received were recurring and, while the amount in financial terms was difficult to accurately quantify, the types and range of benefits received is shown in table 2.

Centre No. FirstRecruitment

CompletedFollow-up

Deceased/declined/other

No. eligible foradditional benefits

1 54 43 (80%) 2 2 7 6(14%)

2 95 82 (86%) 1 4 8 10 (23%)

3 200 147 (74%) 5 29 19 16 (11%)

4 134 83 (62%) 3 47 1 13 (15%)

5 100 89 (89%) 6 5 0 61 (69%)

6 100 77 (77%) 3 12 8 23 (30%)

7 51 43 (84%) 2 2 4 10 (23%)

734 565 22 101 47 139

CentreNo.

AttendanceAllowance

(new)

A.A.up-

grade

Incomesupport

OtherRecurringBenefits

CommunityCare

Grants

Total

1 3 4 0 0 0 72 8 0 0 2 0 103 11 1 4 0 0 164 10 2 1 0 0 135 39 4 13 13 12 816 11 6 5 5 5 327 5 3 4 3 0 15

87 20 27 23 17 174

Table 1:Summary of patients recruited

Table 2:Summary of additional benefits received

Discussion:

This study suggests that many patients over 65 years of age are not claiming their full entitlement to social security benefits. It also suggests that primary care can be used as an effective setting not only to accurately identify those patients who are under claiming but also to assist them to claim their full benefit entitlement. The impact of additional benefits on the health and wellbeing of recipients is currently being evaluated. It is hoped that the demographic data (when correlated with the information on under-claiming of benefits), will help in the development of certain markers. These markers may then assist health care professionals to identify, in the brief time available during consultations, those over 65 who are likely to be under-claiming their benefits.