Stanley Steyer School for Health Professionals, Tel-Aviv University, Tel Aviv, Israel.
The Department of Family Medicine, The Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel.
Isr J Health Policy Res. 2020 Jun 2;9(1):15. doi: 10.1186/s13584-020-00374-5.
Depressive symptoms are often undetected, particularly among older adults. The purpose of this study is to provide information on the prevalence, characteristics, and patterns of depressive symptoms among older adults residing in the community in Israel, and their health-care utilization.
A cross-sectional survey was conducted among a random sample of 2502 members of one HMO in Israel, aged 65+. They were interviewed by telephone with the GDS-15 scale, which serves as the gold standard for depressive symptoms. Data from the computerized medical records of the HMO were added to the interview file, including the diagnosis of depression, purchase of antidepressant medication and use of services.
The average age of respondents was 73; 54% were women. They tended to be older, living alone, suffering from falls and from sleep disorders, and to have poor subjective health status. 24% scored 6+ on the GDS scale. A significant association was found between a GDS score of 6+ and increased hospitalizations, visits to the emergency room and/or to family physicians and specialists.
We found a high prevalence of depression. Its negative effects on the individual and increased costs to the health system, supports the screening and treatment of the disease in the older population. This problem should be a national priority, with screening and treatment becoming part of the national quality of care indicators which would then be implemented by the HMOs as part of an integrated disease management program for the elderly.
抑郁症状常常未被发现，尤其是在老年人中。本研究旨在提供有关以色列社区中老年人抑郁症状的流行率、特征和模式及其医疗保健利用情况的信息。
对以色列一家 HMO 的 2502 名 65 岁以上的随机样本进行了横断面调查。他们通过电话使用 GDS-15 量表进行访谈，该量表是抑郁症状的金标准。HMO 的计算机医疗记录中的数据被添加到访谈文件中，包括抑郁诊断、抗抑郁药物的购买和服务的使用。
受访者的平均年龄为 73 岁；54%为女性。他们往往年龄较大，独居，经常跌倒和患有睡眠障碍，主观健康状况较差。24%的人在 GDS 量表上得分 6+。GDS 得分 6+与住院、急诊室就诊和/或家庭医生和专家就诊次数增加之间存在显著关联。
我们发现抑郁的患病率很高。它对个人的负面影响以及对卫生系统成本的增加，支持对老年人群进行疾病筛查和治疗。这个问题应该是国家的优先事项，将筛查和治疗作为国家医疗质量指标的一部分，然后由 HMO 作为老年人综合疾病管理计划的一部分实施。
