- Title Information
- Title
- Depression and Health Service Utilization in Physically Disabled Medicaid Fee-for-Service Enrollees
- Name:
Personal
- Name Part
- Wieland, Lisa S.
- Role
- Role Term:
Text
- creator
- Origin Information
- Copyright Date
(keyDate="yes", encoding="w3cdtf")
- 2008
- Physical Description
- Extent
- ic, 96 p.
- digitalOrigin
- born digital
- Note
- Thesis (Ph.D.) -- Brown University (2009)
- Name:
Personal
- Name Part
- Allen, Susan
- Role
- Role Term:
Text
- director
- Name:
Personal
- Name Part
- Intrator, Orna
- Role
- Role Term:
Text
- reader
- Name:
Personal
- Name Part
- Pirraglia, Paul
- Role
- Role Term:
Text
- reader
- Name:
Personal
- Name Part
- Dickersin, Kay
- Role
- Role Term:
Text
- reader
- Name:
Corporate
- Name Part
- Brown University. Division of Biology and Medicine. Epidemiology
- Role
- Role Term:
Text
- sponsor
- Genre (aat)
- theses
- Abstract
- Background: Although depression is prevalent among working-aged Medicaid enrollees with physical disabilities, the association of depression and health service utilization has not
been examined in this population. The relationship between depression and validity of self-reported health service utilization has also not been well explored. Objectives: We tested the
hypotheses that depression is associated with both increased non-mental health service utilization and with overreporting of prior health service utilization. Methods: We linked data from a 2001
telephone survey of 556 physically disabled working-age Medicaid enrollees to paid Medicaid claims for the 12 months preceding and following the survey. The association between a claims
diagnosis of depression during the previous year or a survey report of depression, and non-mental health emergency department (ED) or hospital utilization was examined for the 12 months
following the survey. Self-reports of ED visits, hospitalization and inpatient nights during the previous year were compared to paid claims for the 12 months preceding the survey. Agreement
between self-reports and paid claims was compared for respondents who did and did not report recent depressed mood. Results: After adjustment for demographics and physical health, a depression
diagnosis was associated with increased odds of a non-mental health ED visit (OR=2.28, 95% CI = 1.22, 4.26). There was no increase in the odds of hospitalization. Survey respondents reported
more ED and hospital utilization than was contained in paid Medicaid claims. After adjustment for demographics and factors associated with reporting error, recent depressed mood increased
overreports of ED visits by 37% and was associated with overreporting inpatient nights by 1-7 nights. Conclusion: In working-aged adults with disabilities, depression is associated with
increased non-mental health ED use. However, recent depressed mood is associated with greater overreporting of previous ED and hospital utilization. Further research is needed to assess whether
depression may be a modifiable factor in efforts to reduce non-mental health utilization in this population. In the meantime, self-reports of health service use should be used with caution when
assessing the relationship between depression and health service utilization.
- Subject (Local)
- Topic
- Depression
- Subject (Local)
- Topic
- Health Services
- Subject (Local)
- Topic
- Physical Disability
- Subject (FAST)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/890931")
- Topic
- Depression, Mental
- Subject (FAST)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/1013753")
- Topic
- Medical care
- Subject (FAST)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/1013657")
- Topic
- Medicaid
- Record Information
- Record Content Source (marcorg)
- RPB
- Record Creation Date
(encoding="iso8601")
- 20091218
- Language
- Language Term:
Code (ISO639-2B)
- eng
- Language Term:
Text
- English
- Identifier:
DOI
- 10.7301/Z0J101KD
- Access Condition:
rights statement
(href="http://rightsstatements.org/vocab/InC/1.0/")
- In Copyright
- Access Condition:
restriction on access
- Collection is open for research.
- Type of Resource (primo)
- dissertations