USE OF HEALTH-SERVICES BY HOSPITALIZED MEDICALLY ILL DEPRESSED ELDERLY PATIENTS

Objective: The authors examined whether depression is associated with greater use of health services by elderly medical patients before and during hospitalization. Method: Depression and recent use of health se rvices were assessed in 542 patients aged 60 or over who were consecut ively admitted to university medical services. Depression was measured by using the Center for Epidemiologic Studies Depression Scale, the H amilton Depression Rating Scale, and the depressive disorders section of the National Institute of Mental Health Diagnostic Interview Schedu le, which was administered by a psychiatrist. Results: After age, sex, race, education, and severity of medical illness were controlled for, Hamilton depression score significantly predicted hospital days in th e past year, hospital days and total inpatient days (hospital plus nur sing home) in the past 3 months, and number of outpatient medical visi ts in the past 3 months. Depressed patients had more hospital days in the past year and had more hospital days, total inpatient days, and ou tpatient medical visits in the past 3 months than did nondepressed pat ients. Associations between depression and length of index hospital st ay, home health visits, nursing home days, and number of prescription medications disappeared when severity of medical illness was controlle d Mental health visits were no more common among depressed than nondep ressed patients. Conclusions: Depressed elderly medical inpatients use d more hospital and outpatient medical services than nondepressed pati ents, but they did not receive more mental health services. Efforts by primary care physicians and third-party payers to identify and treat depression in this population are needed.