title: Self-reported use of diabetes healthcare services in a Quebec community-based sample: impact of depression status.
abstract: OBJECTIVE
  To ascertain the impact of minor and major depression on self-reported use of and access to diabetes healthcare services, and the care components received in a community-based Quebec sample with type 2 diabetes.
  
  
  METHODS
  Adults with type 2 diabetes who took part in baseline and 1-year follow-up telephone interviews for the Diabetes Health Study were assessed (n = 1175).
  
  
  METHODS
  Information was collected regarding depression status (i.e. minor or major depression), use of and access to diabetes healthcare services, sociodemographic and diabetes characteristics, treatment, diabetes complications, disability, body mass index, residential area and depression.
  
  
  RESULTS
  People with major depression were more likely to be high users or non-users of diabetes healthcare services. The high users reported more diabetes complications. People with major depression also reported more problems with accessing diabetes healthcare services, specifically having to wait too long between making their appointment and their visit, specialist care not being available in their area, general health deterioration, being unable to leave their house due to their health and problems with transportation. People with major depression were less likely to report having their feet checked by their doctor, and were more likely to report problems with getting advice from their doctor.
  
  
  CONCLUSIONS
  People with diabetes need to use healthcare services in order to receive recommended care components. People with major depression and no complications are less likely to report using healthcare services; conversely, people with major depression and complications are more likely to be high users of healthcare services. People with major depression perceive more problems with the health care they receive.
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada. Electronic address: kimberly.smith@douglas.mcgill.ca.
authors.forename: K J
authors.initials: KJ
authors.lastname: Smith
authors.affiliation: Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Gariépy
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada; Montréal Diabetes Research Centre, Montreal, Quebec, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Schmitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000706:statistics & numerical data*; D003863:Depression / Q000150:complications*; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011792:Quebec; D057566:Self Report; D055815:Young Adult
keywords: Access; Depression; Health care; Type 2 diabetes; Utilization