Cross-Sectional Associations of Depressive Symptom Severity and Functioning with Health Service Use by Older People in Low-and-Middle Income Countries

Conal D. Twomey, Martin Prince, Alarcos Cieza, David S. Baldwin and A. Matthew Prina
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Conal D. Twomey: Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton SO17 1BJ, UK
Martin Prince: Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
Alarcos Cieza: Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton SO17 1BJ, UK
David S. Baldwin: Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
A. Matthew Prina: Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK

IJERPH, 2015, vol. 12, issue 4, 1-19

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.

Keywords: depression; functioning; health service use; low-and-middle income countries; cross-sectional (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2015
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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