The quality of medical care for comorbid conditions of depressed elders.
OBJECTIVE
In light of large variation in the quality of medical care, this study assesses the extent to which medical care for depressed elders is consistent with systematic quality standards.


METHODS
Using the Donabedian model, we assess factors related to two quality measures: medical service fit and medical provider contact. We assessed 110 depressed older adults with comorbid conditions through practical guidelines of medical services.


RESULTS
We found large variation in the quality of medical care and differences between two quality measures. Structure (Medigap insurance and clinical factors) and process factors (medical professional visits, ER visits, and adequacy of informal care) influenced the quality of medical care.


CONCLUSIONS
Emphasizing accuracy in quality measures, quality disparities by medical conditions call attention to the risky population with certain conditions targeted for closer follow-up. Appropriate medical care processes can enhance the quality.
Hong
Song-Iee
SI
Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University, St. Louis, Missouri, USA. shong@gwbmail.wustl.edu
Morrow-Howell
Nancy
N
Proctor
Enola
E
Wentz
Joan D
JD
Rubin
Eugene
E
D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D015577:Geriatric Assessment; D017408:Guidelines as Topic; D006302:Health Services Research / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D017054:Insurance, Medigap / Q000706:statistics & numerical data; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010555:Personality Inventory / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000379:methods; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires