Longitudinal Study of Depression and Health Services Use Among Elderly Primary Care Patients

Q: What does this research mean for the field?

Elderly primary care patients who experience depressive symptoms have significantly greater health services utilization, including higher outpatient charges and more emergency room visits, as well as poorer perceived health. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Christopher M. Callahan; Siu L. Hui; Nancy A. Nienaber; Beverly Musick; William M. Tierney

doi:10.1111/j.1532-5415.1994.tb06554.x

August 1, 1994Journal of the American Geriatrics Society

Longitudinal Study of Depression and Health Services Use Among Elderly Primary Care Patients

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Key Points

To evaluate the prevalence, 9-month incidence, and persistence of depressive symptoms among older primary care patients and assess how depression patterns correlate with healthcare utilization and costs.
Prospective cohort study of 1,711 patients aged 60 and older evaluated via the Center for Epidemiologic Studies Depression (CES-D) scale at baseline and 9 months (935 patients were also evaluated at 6 months).
Outpatient healthcare utilization, emergency room visits, and charges were tracked via an electronic medical record system at an urban academic primary care clinic over 9 months.
Depression prevalence (CES-D ≥ 16) was 17.1% at baseline and 18.8% at 9 months (9-month incidence 11.7%), with 47.6% (140/292) of baseline-depressed patients remaining depressed at 9 months.
Patients exceeding the CES-D threshold at any time were more likely to report fair or poor health (69.8% vs 43.7%) and visit the emergency room (40.4% vs 29.4%).
Depressed patients generated 38% more outpatient visits (7.7 vs 5.6) and 61% higher total outpatient charges ($1209 vs $751) compared to patients without depressive symptoms (all P < 0.01).

Structured PICO

P

Population

1,711 primary care patients aged 60 and older at an academic primary care group practice at an urban ambulatory care clinic.

O

Outcome

Prevalence and 9-month incidence of depressive symptoms (measured by CES-D scale) and patterns of health services use

Depressive symptoms in elderly primary care patients are frequent, often persistent, and associated with significantly greater health services use and poorer perceived health.

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Implication

Depressive symptoms were associated with higher outpatient use in elderly primary care; leaves open whether screening or treatment reduces visits or costs.

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Cite This Study

Callahan et al. (1994) studied this question.

synapsesocial.com/papers/6a1285a070647d095066a30d https://doi.org/10.1111/j.1532-5415.1994.tb06554.x

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Longitudinal Study of Depression and Health Services Use Among Elderly Primary Care Patients

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Longitudinal Study of Depression and Health Services Use Among Elderly Primary Care Patients

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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