TY - JOUR
KW - Aged
KW - Chronic Disease
KW - Depression/economics/epidemiology
KW - Family Practice
KW - Female
KW - Health Care Costs
KW - Health Maintenance Organizations/economics/statistics & numerical data/utilization
KW - Health Services/utilization
KW - Humans
KW - Male
KW - Mental Health Services
KW - Prevalence
KW - Prospective Studies
KW - Regression Analysis
KW - United States
AU - J. Unutzer
AU - D. L. Patrick
AU - G. Simon
AU - D. Grembowski
AU - E. Walker
AU - C. Rutter
AU - W. Katon
A1 - 
AB - OBJECTIVE: To examine whether depressive symptoms in older adults contribute to increased cost of general medical services. DESIGN: A 4-year prospective cohort study. SETTING: Four primary care clinics of a large staff-model health maintenance organization (HMO) in Seattle, Wash. PATIENTS: A total of 5012 Medicare enrollees older than 65 years were invited to participate in the study; 2558 subjects (51%) were successfully enrolled. Non-participants were somewhat older and had a higher level of chronic medical illness. MAIN OUTCOME MEASURES: Depressive symptoms as measured by the Center for Epidemiological Studies Depression scale, which was administered as part of a mail survey at baseline, at 2 years, and at 4 years; and total cost of medical services from the perspective of the HMO. Data were obtained from the cost accounting system of the HMO. RESULTS: In this cohort of older adults, depressive symptoms were common, persistent, and associated with a significant increase in the cost of general medical services. This increase was seen for every component of health care costs and was not accounted for by an increase in specialty mental health care. The increase in health care costs remained significant after adjusting for differences in age, sex, and chronic medical illness. CONCLUSIONS: Depressive symptoms in older adults are associated with a significant increase in the cost of medical services, even after adjusting for the severity of chronic medical illness.
BT - JAMA : the journal of the American Medical Association
C5 - Financing & Sustainability; Key & Foundational; Healthcare Disparities; Measures
CP - 20
CY - UNITED STATES
IS - 20
JF - JAMA : the journal of the American Medical Association
N2 - OBJECTIVE: To examine whether depressive symptoms in older adults contribute to increased cost of general medical services. DESIGN: A 4-year prospective cohort study. SETTING: Four primary care clinics of a large staff-model health maintenance organization (HMO) in Seattle, Wash. PATIENTS: A total of 5012 Medicare enrollees older than 65 years were invited to participate in the study; 2558 subjects (51%) were successfully enrolled. Non-participants were somewhat older and had a higher level of chronic medical illness. MAIN OUTCOME MEASURES: Depressive symptoms as measured by the Center for Epidemiological Studies Depression scale, which was administered as part of a mail survey at baseline, at 2 years, and at 4 years; and total cost of medical services from the perspective of the HMO. Data were obtained from the cost accounting system of the HMO. RESULTS: In this cohort of older adults, depressive symptoms were common, persistent, and associated with a significant increase in the cost of general medical services. This increase was seen for every component of health care costs and was not accounted for by an increase in specialty mental health care. The increase in health care costs remained significant after adjusting for differences in age, sex, and chronic medical illness. CONCLUSIONS: Depressive symptoms in older adults are associated with a significant increase in the cost of medical services, even after adjusting for the severity of chronic medical illness.
PP - UNITED STATES
PY - 1997
SN - 0098-7484; 0098-7484
SP - 1618
EP - 1623
EP - 
T1 - Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study
T2 - JAMA : the journal of the American Medical Association
TI - Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study
U1 - Financing & Sustainability; Key & Foundational; Healthcare Disparities; Measures
U2 - 9168292
VL - 277
VO - 0098-7484; 0098-7484
Y1 - 1997
ER -