Association of depressive symptomatology with healthcare utilization among community-dwelling older adults: an electronic medical records-based longitudinal study in Singapore.

OBJECTIVES: Population ageing presents a significant challenge to healthcare systems, as older adults typically have higher rates of healthcare utilization. This study investigates the association of depressive symptoms with healthcare utilization among community-dwelling older adults in Singapore, focusing on emergency department (ED) visits, frequent ED use, and inpatient hospitalizations. METHOD: We analyze data from a nationally representative longitudinal cohort with participants' survey data linked to electronic medical records to measure healthcare utilization outcomes. The analysis sample included 4049 participants (mean age 72.3 years, 52.0% female). We utilize two-part models for ED visits and hospitalizations and logistic regression for frequent ED use. RESULTS: Our findings indicate that higher depressive symptoms were significantly associated with increased odds of ED visits and hospitalizations within the subsequent 12 months. Each unit increase in the depressive symptoms score was linked with 5% higher odds of at least one ED visit and 6% higher odds of hospitalization. Furthermore, depressive symptoms were significantly associated with a 13% increase in the odds of frequent ED use defined as ≥4 visits, or a 10% increase when frequent ED use was defined as ≥3 visits. CONCLUSION: This study adds to the existing literature by providing robust evidence on the longitudinal association between depressive symptoms and healthcare utilization. These findings highlight the need for proactive identification and management of depressive symptoms in older adults to potentially reduce future healthcare burden.