Depression outcomes and quality of postdischarge care of elders hospitalized for major depression.
OBJECTIVE
Elders with depression are disproportionately hospitalized, and they depend on postacute care for recovery. The authors hypothesized that higher quality of postacute care would be associated with better depression outcomes for older adults six months after discharge for inpatient psychiatric care. The study also explored the time frame in which effects of quality of care on depression outcomes were manifested.


METHODS
The sample consisted of 148 elders (ages 60-95 years) who were hospitalized for major depression and discharged to their homes. Quality of care was measured by the extent to which services met patients' needs. Specifically, quality of care was assessed by whether four domains of needs (psychiatric, medical, functional, and psychosocial) were met six weeks and six months postdischarge. Depression outcomes at six months were measured by the Geriatric Depression Scale.


RESULTS
In bivariate analyses at six weeks, no quality-of-care variables were associated with depression outcomes, but in bivariate analyses at six months, quality of functional and psychosocial care was related to depression outcomes. Multivariate analyses revealed that those whose psychosocial needs were unmet at six months showed worse depression outcomes.


CONCLUSIONS
Findings provided partial support for the association between quality of care and depression outcomes, in that quality of psychosocial care was associated with better outcomes. Also, the findings suggest that the relationship between quality of psychosocial care and depression outcomes may be evident after six months of postacute care.
Lee
Mi Jin
MJ
George Warren Brown School of Social Work, Washington University, Campus Box 1196, 1 Brookings Drive, St. Louis, MO 63130, USA. mlee@wustl.edu
Proctor
Enola
E
Morrow-Howell
Nancy
N
D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006301:Health Services Needs and Demand; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011584:Psychology; D011787:Quality of Health Care / Q000592:standards*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome