title: Depressive symptoms, chronic medical illness, and health care utilization: findings from the Korean Longitudinal Study of Ageing (KLoSA).
abstract: BACKGROUND
  This population-based study examined the relative and combined relationships of chronic medical illness (CMI) and depressive symptoms with health care utilization among older adults in South Korea.
  
  
  METHODS
  A nationally representative sample of 3224 older adults participating in the Korean Longitudinal Study of Ageing (KLoSA) were categorized into four groups based on clinical characteristics: CMI only; depressive symptoms only; CMI and depressive symptoms; and neither CMI nor depressive symptoms. We estimated the use of various health care services by the groups while adjusting for clinical and sociodemographic characteristics.
  
  
  RESULTS
  Depressive symptoms, as measured by the short-form Center for Epidemiological Studies-Depression scale (CES-D10), were prevalent, often occurring together with CMI in community-dwelling older adults in South Korea. Having depressive symptoms was positively associated with the use of inpatient services, outpatient physician services, and public health centers. The odds of using health care services were larger among older people with both depressive symptoms and CMI than depressive symptoms only.
  
  
  CONCLUSIONS
  Self-reported depressive symptoms and self-reported CMI are prevalent among older adults in South Korea, often occurring together and possibly increasing health care utilization. These findings imply a need for chronic disease management targeting older people with complex mental and medical conditions and evaluation of its effects on health outcomes and service use.
authors.affiliation: Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
authors.forename: Hongsoo
authors.initials: H
authors.lastname: Kim
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Park
authors.forename: Soong-Nang
authors.initials: SN
authors.lastname: Jang
authors.forename: Soonman
authors.initials: S
authors.lastname: Kwon
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging; D002908:Chronic Disease / Q000453:epidemiology*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D056910:Republic of Korea / Q000453:epidemiology; D012737:Sex Factors; D012959:Socioeconomic Factors