Abstract：
BACKGROUND:Comprehensive understanding of the determinants of health service use (HSU) by older people with depression is essential for health service planning for an ageing global population. This study aimed to determine the extent to which depressive symptom severity and functioning are associated with HSU by older people with depression in low and middle income countries (LMICs). METHODS:A cross-sectional analysis of the 10/66 Dementia Research Group population-based surveys dataset. Participants (n = 4590) were those aged 65 or older, in the clinical range for depressive symptoms (defined as scoring four or more on the EURO-D), living in 13 urban and/or rural catchment areas in nine LMICs. Associations were calculated using Poisson regression and random-effects meta-analysis. RESULTS:After adjustment for confounding variables, (EURO-D) depressive symptom severity was significantly associated with "any community HSU" (Pooled Prevalence Ratios = 1.02; 95% CI = 1.01-1.03) but not hospital admission. Conversely, after adjustment, (WHODAS-II) functioning was significantly associated with hospital admission (Pooled PR = 1.14; 95% CI = 1.02-1.26) but not "any community HSU". CONCLUSIONS:Depressive symptom severity does not explain a large proportion of the variance in HSU by older people with depression in LMICs. The association of functioning with this HSU is worthy of further investigation. In LMICs, variables related to accessibility may be more important correlates of HSU than variables directly related to health problems.
journal_name
Int J Environ Res Public Healthauthors
Twomey CD,Prince M,Cieza A,Baldwin DS,Prina AMdoi
10.3390/ijerph120403774subject
Has Abstractpub_date
2015-04-02 00:00:00pages
3774-92issue
4eissn
1661-7827issn
1660-4601pii
ijerph120403774journal_volume
12pub_type
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