Depressive symptoms not meeting the criteria for major depression (i.e., minor depression or subsyndromal depression) are a serious public health problem in the elderly population. The one-year prevalence is estimated to be as high as 27% among community-dwelling elderly, and the disease burden for these symptoms may be as great as that of all other mood disorders combined. The difficulty in diagnosing depression among the elderly and stigma attached to mental illness can contribute to undertreatment of those who need care or delay receipt of care until the patient is in need of hospitalization. Managed care has the potential to improve access to care through increased benefit coverage, particularly of prescription medications. Managed care also is an incentive to substitute less costly outpatient care for inpatient care. However, little research has examined whether utilization for depression differs under managed care compared with fee for service plans. Using data from the Medical Expenditures Panel Survey, this study examines health care utilization among adults 50 and older who have depressive symptoms. The focus of the analysis is on system-level differences in utilization between patients covered by indemnity insurance (n=239) and managed care (n=119), including a consideration of access to care. The impact of patient-level factors, such as need for assistance with ADLs or IADLs, comorbidities, and demographics, on differences in utilization will be examined. The results of this research have important implications for benefit design and health care policy.
Learning Objectives: At the end of the session, participants will: 1) have a basic understanding of MEPS and of the significance of depressive symptoms in the elderly, 2) be able to identify differences in utilization of health care among older adults with depressive symptoms as they relate to insurance type, and 3) understand which person-level factors contribute the most to these utilization differences
Keywords: Utilization, Depression
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Agency for Healthcare Quality Research (formerly the Agency for Health Care Policy Research)
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.