Chronic Medical Illness, Depression, and Use of Acute Medical Services Among Medicare Beneficiaries

Publication Date:

Publisher: Lippincott Williams & Wilkins

Author(s): S. Himelhoch; W.E. Weller; Albert W. Wu; G.F. Anderson; L.A. Cooper

Research Area: Health

Type: Report

Abstract:

As many as one in four elderly people who are chronically ill are also depressed. Earlier research suggests that they are apt to be sicker and are more likely to die than seniors who are not depressed. To find out whether they are also more likely to need acute medical care, researchers analyzed the records of a random sample of 60,382 depressed, chronically ill patients enrolled in fee-for-service Medicare. Looking at eight common chronic conditions such as diabetes or hypertension, they found that individuals who were depressed were at least twice as likely as those who were chronically ill, but not depressed to use the emergency room or have a preventable hospitalization. This was the first study to demonstrate the connection between depression and acute care in a nationally representative group of seniors. The authors suggest that primary care providers should be aware of the connection and that better coordination of mental health and medical services might help. They write that their findings are limited by the fact that some patients categorized as "not depressed" might have had undiagnosed depression and that their data did not permit them to adjust for possible confounding factors such as education or income.