Healthcare and preventive services utilization of elderly Europeans with depressive symptoms.

doi:10.1016/J.JAD.2007.04.011

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Healthcare and preventive services utilization of elderly Europeans with depressive symptoms.

Journal Article•DOI•

Healthcare and preventive services utilization of elderly Europeans with depressive symptoms.

Isabelle Peytremann-Bridevaux¹, R. Voellinger¹, Brigitte Santos-Eggimann¹•Institutions (1)

University of Lausanne¹

01 Jan 2008-Journal of Affective Disorders (Elsevier)-Vol. 105, Iss: 1, pp 247-252

TL;DR: Share data suggest that patients with depressive symptoms are frequent users of healthcare but not preventive services, and low screening rates may reflect missed screening opportunities rather than a lack of screening opportunities.

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About: This article is published in Journal of Affective Disorders.The article was published on 2008-01-01 and is currently open access. It has received 57 citations till now. The article focuses on the topics: Breast cancer screening.

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Journal Article•DOI•

Receipt of preventive medical care and medical screening for patients with mental illness: a comparative analysis

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Oliver Lord¹, Darren Malone, Alex J. Mitchell², Alex J. Mitchell³•Institutions (3)

University of Leicester¹, Leicester Royal Infirmary², Leicester General Hospital³

01 Sep 2010-General Hospital Psychiatry

TL;DR: There is strong evidence to suggest that the quality of preventive and screening services received by patients with mental illness is often lower, but occasionally superior to that received by individuals who have no comparable mental disorder.

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108 citations

Cites background from "Healthcare and preventive services ..."

...Eight studies showed no effect of mental illness on mammography [33,35,36,38,45–47,50]....
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...This trend was despite a significantly higher use of services in the depressed group [33]....
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...In the large European interview and survey study [33], the group screening positive for a depressive disorder had higher rates of colonoscopy or sigmoidoscopy (16....
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...Neutral association In a large European interview and survey study, the group with high Euro-D scores, suggesting the presence of a depressive disorder, had a trend towards higher flu vaccination, but this was not significant [33]....
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...[33] conducted an interview and questionnaire survey of over 50 years old in 10 European countries (n=15,380); those who scored N3 on the Euro-D were less likely to have a mammogram in the last 2 years, but the adjusted odds ratio was no longer significant (OR 1....
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Journal Article•DOI•

Breast cancer screening in women with mental illness: comparative meta-analysis of mammography uptake

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Alex J. Mitchell¹, Isabel Espirito Santo Pereira¹, Motahare Yadegarfar², Shingai Pepereke, Vongai Mugadza, Brendon Stubbs - Show less +2 more•Institutions (2)

University of Leicester¹, University of Greenwich²

01 Dec 2014-British Journal of Psychiatry

TL;DR: Rates of mammography screening are lower in women with mental illness, particularly women with SMI, and this is not explained by the presence of emotional distress, clearly extend into preventive population screening.

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Abstract: Background There is a higher mortality rate due to cancer in people with mental illness and previous work suggests suboptimal medical care in this population. It remains unclear if this extends to breast cancer population screening. Aims To conduct a systematic review and meta-analysis to establish if women with a mental health condition are less likely to receive mammography screening compared with those without mental ill health. Method Major electronic databases were searched from inception until February 2014. We calculated odds ratios (OR) with a random effects meta-analysis comparing mammography screening rates among women with and without a mental illness. Results were stratified according to primary diagnosis including any mental illness, mood disorders, depression, severe mental illness (SMI), distress and anxiety. Results We identified 24 publications reporting breast cancer screening practices in women with mental illness ( n = 715 705). An additional 5 studies investigating screening for those with distress ( n = 21 491) but no diagnosis of mental disorder were identified. The pooled meta-analysis showed significantly reduced rates of mammography screening in women with mental illness (OR = 0.71, 95% CI 0.66-0.77), mood disorders (OR = 0.83, 95% CI 0.76-0.90) and particularly SMI (OR = 0.54, 95% CI 0.45-0.65). No disparity was evident among women with distress alone. Conclusions Rates of mammography screening are lower in women with mental illness, particularly women with SMI, and this is not explained by the presence of emotional distress. Disparities in medical care due to mental illness clearly extend into preventive population screening.

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100 citations

Cites background from "Healthcare and preventive services ..."

...…et al (2008) 58 (Canada) Green & Pope (2000) 49 Druss et al (2008) 48 (primary care) Masterton et al (2010) 54 (moderate) Pirraglia et al (2004) 52 Peytremann-Bridevaux et al (2008) 51 Carney & Jones (2006) 42 (any low severity) Carney & Jones (2006) 42 (mood disorder low severity) Werneke et al…...
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Journal Article•DOI•

Outcome of depression in later life in primary care: longitudinal cohort study with three years’ follow-up

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E. Strunk, H.W.J. van Marwijk, Trynke Hoekstra, J.W.R. Twisk, M. de Haan, Aartjan T.F. Beekman - Show less +2 more

02 Feb 2009-BMJ

TL;DR: Using readily available prognostic factors (for example, severity of the index episode, a family history of depression, and functional decline) could help direct treatment to those at highest risk of a poor prognosis.

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Abstract: Objectives To study the duration of depression, recovery over time, and predictors of prognosis in an older cohort (≥55 years) in primary care. Design Longitudinal cohort study, with three years’ follow-up. Setting 32 general practices in West Friesland, the Netherlands. Participants 234 patients aged 55 years or more with a prevalent major depressive disorder. Main outcome measures Depression at baseline and every six months using structured diagnostic interviews (primary care evaluation of mental disorders according to diagnoses in Diagnostic and Statistical Manual of Mental Disorders, fourth edition) and a measure of severity of symptoms (Montgomery Asberg depression rating scale). The main outcome measures were time to recovery and the likelihood of recovery at different time points. Multivariable analyses were used to identify variables predicting prognosis. Results The median duration of a major depressive episode was 18.0 months (95% confidence interval 12.8 to 23.1). 35% of depressed patients recovered within one year, 60% within two years, and 68% within three years. A poor outcome was associated with severity of depression at baseline, a family history of depression, and poorer physical functioning. During follow-up functional status remained limited in patients with chronic depression but not in those who had recovered. Conclusion Depression among patients aged 55 years or more in primary care has a poor prognosis. Using readily available prognostic factors (for example, severity of the index episode, a family history of depression, and functional decline) could help direct treatment to those at highest risk of a poor prognosis.

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88 citations

Journal Article•DOI•

Health Service Utilization and Costs of Depressive Symptoms in Late Life - A Systematic Review

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Melanie Luppa¹, Claudia Sikorski, Tom Motzek, Alexander Konnopka, Hans-Helmut König, Steffi G. Riedel-Heller - Show less +2 more•Institutions (1)

Leipzig University¹

30 Nov 2012-Current Pharmaceutical Design

TL;DR: Analysis of research literature regarding health service use and costs of depressive symptoms in late life showed homogeneously that depressive elderly individuals have an increased service use compared to non-depressive, and a one-third increase of outpatient, inpatient, and total healthcare cost of depressive individuals.

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Abstract: Objective: The objective of the study is to systematically analyze and summarize research literature regarding health service use and costs of depressive symptoms in late life. Design: Relevant articles were identified by systematically searching the databases MEDLINE, Web of Science, PSYNDEXplus, PsycINFO, and Cochrane Library. Keywords were ‘depression’ or ‘depressive*’, and ‘cost’ or ‘economic burden’ or ‘utilization’ or ‘use’ and ‘old age’ or ‘elderly’. Studies based on representative samples of elderly individuals aged 55 years and older were included. Results: 55 studies were found, 34 studies determined health service utilization, 10 studies reported costs, and 11 studies reported both. Studies of health service utilization and costs showed homogeneously that depressive elderly individuals have an increased service use compared to non-depressive, and a one-third increase of outpatient, inpatient, and total healthcare costs of depressive individuals. The majority of studies reported antidepressant (AD) use between 20 and 45% by depressive individuals. Mean annual costs for AD ranged from 108 to 305 US$ PPP (purchasing power parities). Increased service use and costs are only to a small proportion related to depression treatment. Conclusions: Depressive symptoms in late life lead to a high economic burden for nations which is not explained by costs for depressive symptom treatment. Strategies for improvement of diagnostic validity and treatment success of depressive symptoms in late life may have an effect on economic burden for societies.

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86 citations

Journal Article•DOI•

Association between forgone care and household income among the elderly in five Western European countries – analyses based on survey data from the SHARE-study

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Andreas Mielck, Raphael Kiess, Olaf von dem Knesebeck¹, Irina Stirbu², Anton E. Kunst² - Show less +1 more•Institutions (2)

University of Hamburg¹, Erasmus University Rotterdam²

23 Mar 2009-BMC Health Services Research

TL;DR: Forgone care should be reduced even if it is not justified by an 'objective' need for health care, as it could be an independent stressor in its own right, and as patient satisfaction is a strong predictor of compliance.

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Abstract: Studies on the association between access to health care and household income have rarely included an assessment of 'forgone care', but this indicator could add to our understanding of the inverse care law. We hypothesize that reporting forgone care is more prevalent in low income groups. The study is based on the 'Survey of Health, Ageing and Retirement in Europe (SHARE)', focusing on the non-institutionalized population aged 50 years or older. Data are included from France, Germany, Greece, Italy and Sweden. The dependent variable is assessed by the following question: During the last twelve months, did you forgo any types of care because of the costs you would have to pay, or because this care was not available or not easily accessible? The main independent variable is household income, adjusted for household size and split into quintiles, calculating the quintile limits for each country separately. Information on age, sex, self assessed health and chronic disease is included as well. Logistic regression models were used for the multivariate analyses. The overall level of forgone care differs considerably between the five countries (e.g. about 10 percent in Greece and 6 percent in Sweden). Low income groups report forgone care more often than high income groups. This association can also be found in analyses restricted to the subsample of persons with chronic disease. Associations between forgone care and income are particularly strong in Germany and Greece. Taking the example of Germany, forgone care in the lowest income quintile is 1.98 times (95% CI: 1.08–3.63) as high as in the highest income quintile. Forgone care should be reduced even if it is not justified by an 'objective' need for health care, as it could be an independent stressor in its own right, and as patient satisfaction is a strong predictor of compliance. These efforts should focus on population groups with particularly high prevalence of forgone care, for example on patients with poor self assessed health, on women, and on low income groups. The inter-country differences point to the need to specify different policy recommendations for different countries.

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86 citations

Cites background or methods from "Healthcare and preventive services ..."

...Methods The study is based on the 'Survey of Health, Ageing and Retirement in Europe (SHARE)', focusing on the noninstitutionalized population aged 50 years or older from 11 European countries plus Israel [16-23]....
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...Shmueli A, Achdut L, Sabag-Endeweld M: Financing the package of services during the first decade of the national health insurance law in Israel: trends and issues....
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...Methods The study is based on the 'Survey of Health, Ageing and Retirement in Europe (SHARE)', focusing on the non- institutionalized population aged 50 years or older from 11 European countries plus Israel [16-23]....
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...2004), and they are well accepted in the public health community [18-23]....
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Journal Article•DOI•

Inequalities in influenza vaccine uptake among people aged over 74 years in Britain.

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Punam Mangtani¹, Elizabeth Breeze¹, Sari Kovats¹, Edmond S. W. Ng¹, Jennifer A. Roberts¹, Astrid E. Fletcher¹ - Show less +2 more•Institutions (1)

University of London¹

01 Aug 2005-Preventive Medicine

TL;DR: Lower uptake in practices in deprived areas supports targeting of resources at the individual level and those who are more isolated require support to access influenza vaccination.

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63 citations

"Healthcare and preventive services ..." refers result in this paper

...The findings of an association between depressive symptoms and preventive services are not consistent with previously published studies (Mangtani et al., 2005; Pirraglia et al., 2004; Werneke et al., 2006), and do not confirm the negative impact of depressive symptoms on receipt of preventive…...
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...The findings of an association between depressive symptoms and preventive services are not consistent with previously published studies (Mangtani et al., 2005; Pirraglia et al., 2004; Werneke et al., 2006), and do not confirm the negative impact of depressive symptoms on receipt of preventive services (breast cancer screening and influenza immunization)....
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...Little research has been published regarding the receipt of preventive services by individuals presenting depressive symptoms, and the results of such research are discordant (Horvitz-Lennon et al., 2006, Lasser et al., 2003, Mangtani et al., 2005, Pirraglia et al., 2004; Werneke et al., 2006)....
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Journal Article•DOI•

Uptake of screening for breast cancer in patients with mental health problems

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Ursula Werneke, Oded Horn, Alan Maryon-Davis, Simon Wessely, Stuart Donnan, Klim McPherson - Show less +2 more

01 Jul 2006-Journal of Epidemiology and Community Health

TL;DR: Women with severe mental health problems may be less likely to attend national screening programmes such as breast screening, and action should be taken to overcome the barriers to attendance.

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Abstract: Objectives: Mental illness is associated with physical illness and mortality from a variety of causes including cancer. There is little information on screening attendance among the mentally ill population. An audit was conducted of a breast screening service in inner London to determine uptake rates in women with mental illness. Design: Cross sectional data linkage study of the local screening register and patients of the local psychiatric units. Screening uptake rates in all patients, those with a history of multiple detentions in hospital, and those with psychosis were compared with the local reference population. Setting: Women in three inner London boroughs. Participants: Screening records for 933 psychiatric patients and 44 195 women without mental health problems aged 50 to 64 years. Main results: Overall, psychiatric patients were as likely as the reference group to attend breast screening. Patients with a history of multiple detention were significantly less likely to attend (OR = 0.40, 0.29 to 0.55; p Conclusion: Women with severe mental health problems may be less likely to attend national screening programmes such as breast screening, and action should be taken to overcome the barriers to attendance.

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54 citations

"Healthcare and preventive services ..." refers result in this paper

...The findings of an association between depressive symptoms and preventive services are not consistent with previously published studies (Mangtani et al., 2005; Pirraglia et al., 2004; Werneke et al., 2006), and do not confirm the negative impact of depressive symptoms on receipt of preventive services (breast cancer screening and influenza immunization)....
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...Little research has been published regarding the receipt of preventive services by individuals presenting depressive symptoms, and the results of such research are discordant (Horvitz-Lennon et al., 2006, Lasser et al., 2003, Mangtani et al., 2005, Pirraglia et al., 2004; Werneke et al., 2006)....
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...…depressive symptoms and preventive services are not consistent with previously published studies (Mangtani et al., 2005; Pirraglia et al., 2004; Werneke et al., 2006), and do not confirm the negative impact of depressive symptoms on receipt of preventive services (breast cancer screening and…...
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Journal Article•DOI•

Geriatric depression, antidepressant treatment, and healthcare utilization in a health maintenance organization.

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Lucy Rose Fischer¹, Feifei Wei¹, Sharon J. Rolnick¹, Jody Jackson¹, William A. Rush¹, Judith Garrard², Nicole M. Nitz², Lori Luepke² - Show less +4 more•Institutions (2)

HealthPartners¹, University of Minnesota²

01 Feb 2002-Journal of the American Geriatrics Society

TL;DR: It was found that patients with depressive symptoms generated more outpatient health care and higher charges but not necessarily more inpatient care, and programs targeted to geriatric patients whose depression is comorbid with other chronic medical conditions might be cost-effective and particularly appropriate for geriatric care.

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Abstract: OBJECTIVES: To assess the separate effects of depressive symptoms and antidepressant treatment on healthcare utilization and cost. SETTING: Social Health Maintenance Organization (HMO) at Health Partners in Minnesota. PARTICIPANTS: Geriatric Social HMO enrollees were screened for depressive symptoms using the 30-item Geriatric Depression Scale. A stratified sample was created, composed of geriatric enrollees with depressive symptoms, with antidepressant prescriptions, or with neither (n = 516). DESIGN: Regression analyses were conducted with separate equations for utilization and charge outcome variables, both outpatient and inpatient (log-transformed). The Charlson Comorbidity Index, age, and gender served as covariates. MEASUREMENT: Depressive symptoms were identified through the Diagnostic Interview Schedule. Antidepressant treatment was determined from the HMO pharmacy database. RESULTS: Having depressive symptoms was associated with a 19% increase in the number of outpatient encounters and a 30% increase in total outpatient charges. Antidepressant treatment was associated with a 32% increase in total outpatient charges but was not significantly associated with number of outpatient encounters. Depressive symptoms and antidepressant therapy were not significantly associated with inpatient utilization or charges. CONCLUSION: This study found that patients with depressive symptoms generated more outpatient health care and higher charges but not necessarily more inpatient care. Our findings suggest that programs targeted to geriatric patients whose depression is comorbid with other chronic medical conditions might be cost-effective and particularly appropriate for geriatric care.

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49 citations

"Healthcare and preventive services ..." refers result in this paper

...Concordant with previous population-based studies from several countries (Beekman et al., 1997; Fischer et al., 2002; Himelhoch et al., 2004; McCracken et al., 2006; Rowan et al., 2002), our results reveal an association between depressive symptoms and general healthcare use, which was not fully…...
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...Concordant with previous population-based studies from several countries (Beekman et al., 1997; Fischer et al., 2002; Himelhoch et al., 2004; McCracken et al., 2006; Rowan et al., 2002), our results reveal an association between depressive symptoms and general healthcare use, which was not fully explained by chronic diseases and/or disability....
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Journal Article•DOI•

Health service use by adults with depression: community survey in five European countries - Evidence from the ODIN study

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Cherie McCracken¹, Odd Steffen Dalgard¹, José Luis Ayuso-Mateos¹, Patricia Casey, Greg Wilkinson, Ville Lehtinen, Christopher Dowrick - Show less +3 more•Institutions (1)

University of Liverpool¹

01 Aug 2006-British Journal of Psychiatry

TL;DR: The association between social support and service use suggests that interventions may be needed for those who lack social support, and individual participant factors provided greater explanatory power than national differences in healthcare delivery.

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Abstract: Background Little is known about patterns of healthcare use by people with depression in Europe. Aims To examine the use and cost of services by adults with depressive or adjustment disorders in five European countries, and predictive factors. Method People aged 18-65 years with depressive or adjustment disorders ( n =427) in Ireland, Finland, Norway, Spain and the UK provided information on predisposition (demographics, social support), enablement (country, urban/rural, social function) and need (symptom severity, perceived health status) for services. Outcome measures were self-reported use Client Services Receipt Interview and costs of general practice, generic, psychiatricor social services in the past 6 months. Results Less frequent use was made of generic services in Norway and psychiatric services in the UK. Severity of depression, perceived health status, social functioning and level of social support were significant predictors of use; the number of people able to provide support was positively associated with greater health service use. Conclusions Individual participant factors provided greater explanatory power than national differences in healthcare delivery. The association between social support and service use suggests that interventions may be needed for those who lack social support.

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47 citations

"Healthcare and preventive services ..." refers result in this paper

...Concordant with previous population-based studies from several countries (Beekman et al., 1997; Fischer et al., 2002; Himelhoch et al., 2004; McCracken et al., 2006; Rowan et al., 2002), our results reveal an association between depressive symptoms and general healthcare use, which was not fully…...
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Journal Article•DOI•

Do women who screen positive for mental disorders in primary care have lower mammography rates

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Karen E. Lasser¹, Hamza Zeytinoglu¹, Elizabeth Miller², Anne E. Becker², Richard C. Hermann², David H. Bor¹ - Show less +2 more•Institutions (2)

Cambridge Health Alliance¹, Harvard University²

01 May 2003-General Hospital Psychiatry

TL;DR: There were no significant differences in mammography rates among women who screened negative and positive for any mental illness, and Screening for mental disorders in primary care does not appear to identify women at risk for nonreceipt of mammography.

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35 citations