218299 Persistent depression and multimorbidity among Veterans

Tuesday, November 9, 2010

Patricia A. Findley, DrPH, MSW , School of Social Work, Rutgers,The State University of New Jersey, New Brunswick, NJ
Chan Shen, PhD , Economics, George Washington University, New Brunswick, NJ
Usha Sambamoorthi, PhD , Pharmaceutical Systems and Policy, School of Pharmacy, Morgantown, WV
Objectives: To estimate the association between multimorbidity and persistent depression among cohorts of veterans with diabetes or heart disease or hypertension.

Methods: Retrospective longitudinal analysis of fiscal years 2001 and 2002 data on about 1.38 million Veteran Health Administration (VHA) clinic users with diabetes or heart disease or hypertension. International Classification of Diseases, 9th edition Clinical Modification codes from merged VHA and Medicare claims files were used to identify diabetes, heart disease, hypertension, and depression. Multimorbidty was defined as the concurrent presence of two or more chronic conditions (i.e. diabetes, heart disease, and hypertension). Chi-square tests and multinomial logistic regressions were used to characterize veterans with persistent depression.

Results: Of all veterans diagnosed with diabetes or heart disease or hypertension using VHA clinics, 5.6% were diagnosed with persistent depression. Compared to no depression, persistent depression was significantly more likely among VHA users with multimorbidity. The adjusted odds ratio for VHA users with all three chronic conditions (i.e. diabetes and heart disease and hypertension) was 1.28.

Conclusions: Persistent depression was more likely among VHA users with multimorbidity. These individuals may have intensive long-term healthcare utilization and need extensive coordination of services spanning a broad spectrum health services including medical and mental health services.

Learning Areas:
Administration, management, leadership
Chronic disease management and prevention
Epidemiology
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Define persistent depression using claims or administrative data. Define multimorbidity in physical illnesses using claims or administrative data. Profile characteristics of veterans with persistent depression.

Keywords: Mental Illness, Chronic Illness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I concepualized the subject, directed data analysis, wrote up the abstract. I have been a health services researcher focusing on the interaction between mental and physical health for over 20 years.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
VA HSR&D Research I was the prinicipal investigator for the project funded by VA from July 2006 until 2009 December.

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4242.0: Veterans, homelessness and integrated services