The 130th Annual Meeting of APHA

Abstract #45725

Ayse Akincigil, MA¹, James Walkup, PhD², Stephen Crystal, PhD², Michelle Kennedy, BA¹, and Usha Sambamoorthi, PhD². (1) Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey, 30 College Avenue, New Brunswick, NJ 08901, 732-932-8111, aakinci@rci.rutgers.edu, (2) Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Ave, New Brunswick, NJ 08901

Research Objective: Describe rates and predictors of depression diagnosis and treatment among elderly in ambulatory care settings. Study Design: A national sample of patient visits to physician offices and hospital outpatient departments from the 1997 and 1999 National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS). Bivariate and multivariate techniques were used to analyze the predictors of diagnosis of depression and treatment conditional on depression diagnosis. Diagnosis of depression was identified with ICD-9-CM diagnosis codes recorded during the ambulatory care visits. Treatment included prescription of antidepressants, the administration of psychotherapy or both. Population Studied: Visits to the ambulatory care settings by patients aged 65 or older. Principal Findings: The estimated rate of diagnosed depression was 1.73 per 100 visits. Controlling for other factors, females, whites, patients living in an urban area, and patients with a chronic problem were more likely to be diagnosed with depression. Shorter duration of visits and comorbid medical conditions also reduced the probability of depression diagnosis. Once depression was diagnosed, a majority (79%) received treatment. After controlling for other covariates, only visits with a diagnosis of major depression had higher odds of receiving treatment compared to other depression diagnoses. Conclusions: This study provides evidence of differences in the diagnosis of depression among groups of elderly. Further studies are needed to distinguish the source of disparities: underdiagnosis or lower prevalence of depression in these sub-populations. Findings suggest disparities in depression care stem from recognition rather than treatment.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to (
• identify sub-populations of elderly that are more likely to be diagnosed with depression and (
• identify the factors that are correlated to receiving treatment.

Presenting author's disclosure statement:
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.