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Cross-sectional associations of depressive symptom severity and functioning with health service use by older people in low-and-middle income countries

Cross-sectional associations of depressive symptom severity and functioning with health service use by older people in low-and-middle income countries
Cross-sectional associations of depressive symptom severity and functioning with health service use by older people in low-and-middle income countries
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.
depression, functioning, health service use, low-and-middle income countries, cross-sectional
1660-4601
3774-3792
Twomey, Conal
b9c5a2e5-332a-4664-b592-4b1363f983ad
Prince, Martin
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Cieza, Alarcos
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Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Prina, Matthew
64f0774b-c048-424c-b48e-dbf1a8bc3fcc
Twomey, Conal
b9c5a2e5-332a-4664-b592-4b1363f983ad
Prince, Martin
ff242776-7147-4b2a-96ac-05f2c8f008e3
Cieza, Alarcos
a0df25c5-ee2c-4580-82b3-d0a75591580e
Baldwin, David S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Prina, Matthew
64f0774b-c048-424c-b48e-dbf1a8bc3fcc

Twomey, Conal, Prince, Martin, Cieza, Alarcos, Baldwin, David S. and Prina, Matthew (2015) Cross-sectional associations of depressive symptom severity and functioning with health service use by older people in low-and-middle income countries. [in special issue: Disability and Public Health] International Journal of Environmental Research and Public Health, 12, 3774-3792. (doi:10.3390/ijerph120403774). (PMID:25849540)

Record type: Article

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.

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Accepted/In Press date: 25 March 2015
e-pub ahead of print date: 2 April 2015
Published date: 2 April 2015
Keywords: depression, functioning, health service use, low-and-middle income countries, cross-sectional
Organisations: Psychology, Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 376029
URI: https://eprints.soton.ac.uk/id/eprint/376029
ISSN: 1660-4601
PURE UUID: cd354445-6f69-4879-9ba0-ebb10967dc9c

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Date deposited: 21 Apr 2015 13:44
Last modified: 19 Jul 2019 20:48

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Contributors

Author: Conal Twomey
Author: Martin Prince
Author: Alarcos Cieza
Author: Matthew Prina

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