3259.0: Monday, November 13, 2000 - 8:30 PM

Abstract #13757

Resource utilization and absenteeism in primary care patients: Relationship with three measures of psychological distress

James W. Shaw, PharmD1, Michael Treglia, PhD2, and Stephen Joel Coons, PhD1. (1) College of Pharmacy, The University of Arizona, PO Box 210207, 1703 East mabel St, Tucson, AZ 85721, 520-626-4452, shaw@pharmacy.arizona.edu, (2) Global Health Outcomes Reseach, Eli Lilly and Company, 1 Lilly Corporate Center, DC 1834, Indianapolis, IN 46285

As part of an investigation of depression screening in primary care, this research explored associations of resource utilization and absenteeism with scores on the Center for Epidemiologic Studies Depression scale (CES-D), 5-item Mental Health Inventory (MHI-5), and 12-item Short-Form Health Survey (SF-12) Mental Component Summary (MCS-12). Data were taken from the Longitudinal Investigation of Depression Outcomes. Primary care patients in six countries were asked to complete a questionnaire that included the CES-D, MHI-5, and MCS-12. Patients were also asked to provide information on the number of physician visits, days spent in hospital, and days absent from work in the three months prior to assessment. Multivariate regression models for count data were used to assess relationships between these variables and scores on the CES-D, MHI-5, and MCS-12. Specification tests for non-nested hypotheses were used to make comparisons between models. All three measures were found to be predictive of resource use and absenteeism. Models including MCS-12 score provided a better fit for the observed data than models including CES-D or MHI-5 score (p<0.001). The most significant predictors of resource use and work absence were the covariates physical health status, as measured by the SF-12 Physical Component Summary, and country of residence. The latter may have been associated with differences in access to care. Self-reported measures of psychological distress appear to be predictive of utilization and absenteeism in primary care patients. Controlling for covariates, the MCS-12 appears to provide a better explanation of resource use and work absence than the CES-D or MHI-5.

Learning Objectives: At the conclusion of this presentation, the learner will be able to:

  1. Identify the drivers of resource utilization and absenteeism in primary care patients who are symptomatic for depression.
  2. Articulate the association of medical care utilization and absenteeism with scores on self-reported measures of psychological distress.
  3. Utilize the presented information to develop appropriate studies for assessing resource use in primary care patients with major depression or depressive symptoms.
  4. Describe how model specification tests and likelihood-based indicators of goodness of fit may be used to make comparisons between explanatory variables while controlling for a common set of covariates.

Keywords: Depression, Utilization

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA