Depression and service utilization in elderly primary care patients.
The authors analyzed the relationship between a provider's diagnosis of depression and health services utilization among all elderly patients (N=3,481) seen in a primary care practice over 12 months. Of patients with a diagnosis of depression, 29.7% were given an antidepressant. Depressed patients had increased outpatient resource utilization, including frequency of appointments, number of laboratory tests, X-rays and scans, and consultations. This association remained significant after controlling for comorbidity. On average, patients who were depressed had two more appointments per year. No difference in total cost of hospitalization was observed between the two groups. This study also demonstrated a higher incidence of nonspecific medical complaints in depressed vs. non-depressed elderly primary care patients, and all such nonspecific symptoms were associated with increased total ambulatory costs, tests and consultations. The somatic presentation of depression may contribute to the increased services utilization.
Luber
M P
MP
Department of Psychiatry, University of Pennsylvania, USA.
Meyers
B S
BS
Williams-Russo
P G
PG
Hollenberg
J P
JP
DiDomenico
T N
TN
Charlson
M E
ME
Alexopoulos
G S
GS
D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D015897:Comorbidity; D003866:Depressive Disorder / Q000191:economics / Q000453:epidemiology; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006299:Health Services for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009519:New York City / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data