Depression, Service Utilization, and Treatment Costs Among Medicare Elderly: Gender Differences

Burns, Myron J.; Cain, Van A.; Husaini, Baqar A.

doi:10.1300/j027v19n03_03

Cited by 24 publications

(19 citation statements)

References 8 publications

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“…In study carried out by Burns et al, total health care costs were higher for males than females [40]. In addition, Orueta et al [31] demonstrated that once adjusted per number of chronic conditions and socioeconomic characteristics, individual cost for females was lower than for males for all ages but in the range of 18–44 years old, as expected due to obstetric care.…”

Section: Discussionmentioning

confidence: 97%

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

Alonso-Morán

Satylganova²,

Orueta

et al. 2014

BMC Public Health

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BackgroundThe aim of the study was to estimate the prevalence of depression in the population diagnosed with diabetes type 2 and to test the hypothesis that the presence of depression in such cases was associated with a) worse glycaemic control, and b) higher healthcare costs.MethodsWe conducted a cross-sectional analysis, from 1st September 2010 to 31st August 2011, among patients with type 2 diabetes aged 35 years and over in the Basque Country. It was identified how many of them had also depression. The database included administrative individual level information on age, sex, healthcare costs, other comorbidities, and values of glycaemic control (HbA1c). Deprivation index variable was used as socioeconomic measure and, to observe the coexistent pathologies, all the patients diagnoses were categorized by Adjusted Clinical Groups. We used a measure of association, a logistic and a linear regression for analysis.Results12.392 (9.8%) of type 2 diabetes patients were diagnosed with depression, being the prevalence 5.2% for males and 15.1% for females. This comorbidity was higher among the most deprived population. There was no association between the presence of depression and glycaemic control. We estimated that the comorbidity average cost per patient/year was 516€ higher than in patients with just type 2 diabetes (P < 0.001) adjusted by the other covariates.ConclusionsWe did not find any relationship between depression and glycaemic control in patients with type 2 diabetes. However, the comorbidity was associated with significantly high healthcare costs compared to that of type 2 diabetes occurring alone, after adjusting by other illness. Thus, there is a need of more precise recognition, screening and monitoring of depression among diabetic population. Evidence-based treatment for depression should be included in type 2 diabetes clinical guidelines.

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Section: Discussionmentioning

confidence: 97%

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

Alonso-Morán

Satylganova²,

Orueta

et al. 2014

BMC Public Health

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“…11,[27][28][29] Patients with depression use more healthcare resources, including clinician visits and hospital admissions. 30,31 However, despite higher utilization rates, routine care such as screening may be overlooked. Patients and providers may be overly focused on managing the depression, or they may assume it is a natural consequence of events associated with aging, such as the loss of loved ones or medical illness, and appropriate proper treatment may not be considered.…”

Section: Discussionmentioning

confidence: 99%

Are Depressive Symptoms Associated with Cancer Screening and Cancer Stage at Diagnosis among Postmenopausal Women? The Women's Health Initiative Observational Cohort

Aggarwal

Freund

Sato

et al. 2008

Journal of Women's Health

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Background: Women with depressive symptoms may use preventive services less frequently and experience poorer health outcomes. We investigated the association of depressive symptoms with breast and colorectal cancer screening rates and stage of cancer among a cohort of postmenopausal women. Methods: In The Women's Health Initiative Observational Study, 93,676 women were followed on average for 7.6 years. Depressive symptoms were measured at baseline and at 3 years using the 6-item scale from the Center for Epidemiological Studies Depression scale (CES-D). We calculated a cancer screening rate expressed as a proportion of the years that women were current with recommended cancer screening over the number of follow-up visits in the study. Breast and colorectal cancers were staged based on Surveillance, Epidemiology and End Results (SEER) classification. Results: At baseline, 15.8% (12,621) women were positive for depressive symptoms, and 6.9% (4,777) were positive at both baseline screening and at 3 years. The overall average screening rate was 71% for breast cancer and 53% for colorectal cancer. The breast cancer screening rate was 1.5% (CI 0.9%-2.0%) lower among women who reported depressive symptoms at baseline than among those who did not. Depressive symptoms were not a predictor for colorectal cancer screening. Stage of breast and colorectal cancer was not found to be associated with depressive symptoms after adjusting for covariates. Conclusions: Among a healthy and self-motivated cohort of women, self-reported depressive symptoms were associated with lower rates of screening mammography but not with colorectal cancer screening.

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“…In non-Asian populations, elderly women on Medicare tend to utilize outpatient mental health services for depression more than elderly men on Medicare (Burns, Cain, & Hussaini, 2001; Husaini et al, 2002). In the last few years, studies have indicated potential gender differences in depressive symptoms and the rates of elderly individuals seeking depression treatment (Jang, Kim, & Chiriboga, 2010; Park et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Mental health service utilization among Korean elders in Korean churches: preliminary findings from the Memory and Aging Study of Koreans in Maryland (MASK-MD)

Lee

Han

Huh

et al. 2013

Aging & Mental Health

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Background Korean Americans (KA) comprise the fourth largest Asian-American subgroup, with a population estimated at nearly 1.7 million, and the vast majority (up to 85%) of KA elders attends ethnic churches. Despite the rapid increase of the KA elderly population, data on mental health service utilization among KA elders are scarce. Method Based on a cluster sampling method, the Memory and Aging Study among Koreans in Maryland (MASK-MD) recruited and assessed 630 KA elders (mean age: 70.9 ± 6.1 years; 68.9% female) in KA churches for depression, dementia, and level of mental health service utilization. The Korean versions of the Patient Health Questionnaire (PHQ-9K) and Mini-mental Status Examination (MMSE-KC) were administered by trained community health workers. Results Of the 630 participants, 23.2% and 7.3% had PHQ-9 scores of 5 (‘mild depression’) or above and 10 or above (‘clinical depression’), respectively. In addition, 7.0% scored below the age- and education-specific cutoff values for probable dementia based on the MMSE-KC. Of the 92 participants with ‘clinical depression’ or having thoughts of death or self-injury, only 16 (17%) reported utilizing mental health services. Likewise, of 56 participants with probable dementia, only 3 (7.3%) sought treatment from a health care provider. Conclusion The prevalence of depression and cognitive impairment are high in community-dwelling KA elders attending KA churches, but the rate of mental health service utilization among depressed or cognitively impaired Korean elders is low. Further research is warranted to identify barriers to and strategies for adequate mental health care for Korean immigrant elders.

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Depression, Service Utilization, and Treatment Costs Among Medicare Elderly: Gender Differences

Abstract: The results indicate that mood disorders, outpatient services, and total mental health costs are higher for females than males; however, total health care costs are higher for males than females.

Cited by 24 publications

References 8 publications

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs

Are Depressive Symptoms Associated with Cancer Screening and Cancer Stage at Diagnosis among Postmenopausal Women? The Women's Health Initiative Observational Cohort

Mental health service utilization among Korean elders in Korean churches: preliminary findings from the Memory and Aging Study of Koreans in Maryland (MASK-MD)

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