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Mental health-related quality of life (HRQOL) measures as predictors of cardiac hospitalization

Conway S, Gold, Dominick K, Ahern F, & Heller D. (2001, March 21st–24th). Presentation at the 22nd Annual Meeting of the Society of Behavioral Medicine, Seattle, WA

A major focus in healthcare today is the connection between mental and physical health. This study examined the ability of HRQOL measures to predict hospitalization, specifically for cardiac-related events, during a 12-month follow-up period. Subjects included 37,262 elderly (mean age 79.0 years; 76.8% women; 93.% Caucasian, 5.1% African-American; 1.1% other) enrolled in Pennsylvania's Pharmaceutical Contract for the Elderly who completed the CDC's Behavioral Risk Factor Surveillance System HRQOL module. HRQOL questions included the number of days out of the past 30 respondents reported: 1) not good mental health; 2) feeling sad, blue, or depressed; 3) feeling worried tense or anxious. A score of greater than or equal to 14 days was used as an indicator of poor mental health, depressive symptoms, and anxiety, respectively. Logistic regression models controlling for age, gender, and physical health (indicated by drug categories prescribed) examined the relationship of HRQOL variables to general hospitalization as well as hospitalization for cardiac ischemia [further subdivided into acute myocardial infarctions (AMI) and angina]. Poor mental health (OR=1.645), depressive symptoms (OR=1.648) and anxiety (OR=1.629) were significant predictors of hospitalization (p<0.01). All three variables also significantly predicted cardiac ischemia hospitalization (poor mental health OR=1.490; depressive symptoms OR=1.478; anxiety OR=1.526, p<0.01) and angina hospitalization (poor mental health was the only significant predictor of AMI hospitalization (OR=1.313, p<0.018). Results indicate that psychological HRQOL factors are significant predictors of cardiac hospitalization among the elderly. Early intervention strategies developed to address psychological and emotional needs of this group may lead to a reduction in cardiac-related hospitalizations.

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