title: Associations among indicators of depression in Medicaid-eligible community-dwelling older adults.
abstract: OBJECTIVE
  The purpose of this research was to examine associations among 2 separate Minimum Data Set-Home Care (MDS-HC) depression measures (the Depression Rating Scale [DRS] and medical diagnosis of depression) with billed antidepressant medications in Medicaid paid claim files.
  
  
  METHODS
  The sample for this cross-sectional research included 3,041 Medicaid-eligible older adult participants in a Home and Community Based Waiver Program and used data from the MDS-HC, Version 1 and Medicaid Paid Claim Files. Sensitivity and specificity analyses, receiver operating characteristic (ROC) curve analysis, and t tests were utilized.
  
  
  RESULTS
  DRS scoring indicated that 15.4% of participants had behaviors indicative of depression, whereas 42% had a medical diagnosis of depression noted in the MDS-HC. Of those with a medical diagnosis of depression, 51% had a prescribed antidepressant medication. ROC analysis suggested that the DRS was a poor distinguisher of participants with and without a medical diagnosis of depression or prescribed antidepressant medications.
  
  
  CONCLUSIONS
  Approximately half of Medicaid-eligible older adults medically diagnosed with depression were treated pharmacologically. Longitudinal research is recommended to assess responsiveness of the DRS over time to pharmacological and psychotherapeutic interventions for depression.
authors.affiliation: Department of Nursing, Calvin College, Science Building, 1734 Knollcrest Circle SE, Grand Rapids, MI 49546-4403, USA. eb36@calvin.edu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Byma
authors.forename: Charles W
authors.initials: CW
authors.lastname: Given
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Given
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014481:United States
chemical_list: D000928:Antidepressive Agents
keywords: Depression; Home and Community Based Services; Measurement; Medicaid/Medicare; Mental health (services, therapy)