title: Current depression as a potential barrier to health care utilization in adult cancer survivors.
abstract: Depression in cancer survivors is a major concern and is associated with poor health related quality of life (HRQOL). Delaying or forgoing care due to depression may further augment poor HRQOL. Although several studies have documented depression as a barrier to health care utilization in non-cancer populations, the impact of current depression on health care utilization among adult cancer survivors (ACS) has not been fully elucidated. The objective of this study was to examine the association between current depression and health care utlization among ACS.
  
  
  
  Data from the 2010 Behavioral Risk Factor Surveillance System involving ACS were used in this study. The Patient Health Questionnaire 8 (PHQ-8) item scale was used to measure current depression. Two indicators of health care utilization were examined as outcomes of interest: cost as a barrier to medical care and not having a routine care. Logistic regression models were used to examine the association between current depression and health care utilization.
  
  
  
  Overall, 13.0% of ACS reported symptoms of current depression. Despite no differences in having access to care, current depression in ACS was a significant barrier to health care utilization: cost as a barrier to medical care (AOR: 5.3 [95% CI: 3.1-9.1]), and not having a routine care (AOR: 2.0 [95% CI: 1.2-3.3]).
  
  
  
  Our findings have implications for future studies to further understand the association between depression and health care utlization among ACS, its impact on their overall wellbeing, and efforts to detect and treat depression in ACS. Routine assessment of depression in ACS and effective treatment interventions may aid in seeking timely and appropriate medical care.
authors: Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Hilltop Drive, 320 Lowry Hall Kent, OH, 44242, United States. Electronic address: vcheruvu@kent.edu.
authors: Vinay K
authors: VK
authors: Cheruvu
authors: Master of Public Health Program, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States.
authors: S Cristina
authors: SC
authors: Oancea
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009369:Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011788:Quality of Life; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Adult cancer survivors; Depression; Health care access; Health care utilization; Mental health