Depressive symptoms and health care utilization among adults with asthma.
Katz-PP; Yelin-EH; Eisner-MD; Blanc-PD
Am J Respir Crit Care Med 2003 Apr; 167(7):A967
Depression has been linked to greater health care use. We estimated the association between depressive symptoms (DEP_SX) and health care use among a group of adults with asthma. We analyzed cross-sectional data from an ongoing study of adults with asthma surveyed by telephone (n=439). Depressive symptoms (DEP_SX) were defined as a CES-D score >= 16. Use of both traditional health care (# physician visits, treatment in an emergency room, any hospitalization) and alternative treatments (any herbal treatments, # treatments from alternative providers) for asthma over the past 12 months was assessed. Regression analyses were conducted to examine the relationship between DEP_SX and utilization using the following covariates: age, sex, race, education, marital status, comorbid conditions, smoking status, and severity of asthma score. 29% (n=129) had CES-D scores indicative of possible DEP_SX. DEP_SX were associated with a greater number of asthma-related outpatient visits (p < .05), but no increase in the likelihood of emergency department treatment (OR = .97 [95% CI .48,1.99]) or hospitalization (1.91[.60,6.13]) because of asthma. DEP_SX were also associated with a greater number of visits to alternative providers (p < .05) and a greater likelihood of using herbal treatments (2.29 [1.34, 3.92]) for asthma. DEP_SX were significantly associated with some types of health care utilization among adults with asthma. This association is noted for the types of utilization over which patients have discretion (outpatient physician visits, alternative treatment use), but not for hospitalization or emergency department treatment.
Bronchial-asthma; Pulmonary-system-disorders; Respiratory-system-disorders; Age-factors; Racial-factors; Sex-factors; Education; Demographic-characteristics
Abstract; Conference/Symposia Proceedings
Research Tools and Approaches: Social and Economic Consequences
American Journal of Respiratory and Critical Care Medicine, 2003 International Conference, The American Thoracic Society, Seattle, WA, May 16-21, 2003
University of California, Cardiovascular Research Institute, San Francisco, California 94143