School of Social Policy and Practice, University of Pennsylvania, Philadelphia.
Rush University Medical Center, Chicago, Illinois.
Gerontologist. 2019 May 17;59(3):447-455. doi: 10.1093/geront/gny010.
Depressive symptomatology is a significant predictor of increased health services utilization and health care cost in the general older adult population. However, there is scant information on the relationship between depressive symptoms and health service utilization among U.S. Chinese older adults. The objective of this study was to examine the relationship between depressive symptoms and physician visits, emergency department (ED) visits, and hospitalization.
Cross-sectional data were derived from the Population Study of Chinese Elderly in Chicago (PINE) collected between July 2011 and June 2013 (N = 3,159). Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). Bivariate and multivariate logistic regression analyses were conducted to examine the relationship between depressive symptoms and physician visits, ED visits, and hospitalization.
U.S. Chinese older adults with depressive symptoms were more likely to have at least one ED visit (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.44-2.28) and hospitalization (OR = 1.9, 95% CI = 1.47-2.33) in the past 2 years than those without depressive symptoms, while adjusting for sociodemographic and health-related covariates. Other significant factors associated with health services utilization in this population included number of people in household, health insurance coverage, and acculturation.
Depressive symptoms are positively associated with hospitalization and ED visits among U.S. Chinese older adults. Routine screenings of depressive symptoms should be part of the clinical encounter in these care settings so that appropriate treatment or timely mental health service referrals could be provided to this population to ultimately optimize their utilization of health services.
抑郁症状是一般老年人群中健康服务利用增加和医疗保健费用增加的重要预测因素。然而，关于美国华裔老年人抑郁症状与健康服务利用之间的关系，信息甚少。本研究的目的是探讨抑郁症状与医生就诊、急诊就诊和住院之间的关系。
横断面数据来自于 2011 年 7 月至 2013 年 6 月期间在芝加哥进行的华裔老年人人口研究（PINE）（N=3159）。抑郁症状采用 9 项患者健康问卷（PHQ-9）进行测量。采用双变量和多变量逻辑回归分析来检验抑郁症状与医生就诊、急诊就诊和住院之间的关系。
与无抑郁症状的老年人相比，有抑郁症状的美国华裔老年人在过去 2 年内更有可能至少有一次急诊就诊（比值比[OR] = 1.8，95%置信区间[CI] = 1.44-2.28）和住院（OR = 1.9，95% CI = 1.47-2.33），同时调整了社会人口统计学和健康相关的混杂因素。该人群中与健康服务利用相关的其他重要因素包括家庭人口数、医疗保险覆盖范围和文化适应。
抑郁症状与美国华裔老年人的住院和急诊就诊呈正相关。在这些医疗环境中，应将抑郁症状的常规筛查作为临床就诊的一部分，以便为该人群提供适当的治疗或及时的心理健康服务转介，最终优化他们对健康服务的利用。
