Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-16T16:00:43.386Z Has data issue: false hasContentIssue false

Depressive symptoms, chronic medical illness, and health care utilization: findings from the Korean Longitudinal Study of Ageing (KLoSA)

Published online by Cambridge University Press:  22 March 2011

Hongsoo Kim
Affiliation:
Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
Sang-Min Park
Affiliation:
Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea
Soong-Nang Jang
Affiliation:
Department of Nursing, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
Soonman Kwon*
Affiliation:
Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
*
Correspondence should be addressed to: Professor Soonman Kwon, Graduate School of Public Health and Institute of Health and Environment, Seoul National University, 599 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea. Phone: +82 2-880-2721; Fax: +82 2-762-2888. Email: kwons@snu.ac.kr.

Abstract

Background: This population-based study examined the relative and combined relationships of chronic medical illness (CMI) and depressive symptoms with health care utilization among older adults in South Korea.

Methods: A nationally representative sample of 3224 older adults participating in the Korean Longitudinal Study of Ageing (KLoSA) were categorized into four groups based on clinical characteristics: CMI only; depressive symptoms only; CMI and depressive symptoms; and neither CMI nor depressive symptoms. We estimated the use of various health care services by the groups while adjusting for clinical and sociodemographic characteristics.

Results: Depressive symptoms, as measured by the short-form Center for Epidemiological Studies-Depression scale (CES-D10), were prevalent, often occurring together with CMI in community-dwelling older adults in South Korea. Having depressive symptoms was positively associated with the use of inpatient services, outpatient physician services, and public health centers. The odds of using health care services were larger among older people with both depressive symptoms and CMI than depressive symptoms only.

Conclusions: Self-reported depressive symptoms and self-reported CMI are prevalent among older adults in South Korea, often occurring together and possibly increasing health care utilization. These findings imply a need for chronic disease management targeting older people with complex mental and medical conditions and evaluation of its effects on health outcomes and service use.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S. (2005). Depression in the elderly. Lancet, 365, 19611970.CrossRefGoogle ScholarPubMed
Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior, 36, 110.CrossRefGoogle ScholarPubMed
Beekman, A. T., Deeg, D. J., Braam, A. W., Smit, J. H. and van Tilburg, W. (1997). Consequences of major and minor depression in later life: a study of disability, well-being and service utilization. Psychological Medicine, 27, 13971409.CrossRefGoogle ScholarPubMed
Cheng, S. T. and Chan, A. C. (2005). The Center for Epidemiologic Studies Depression Scale in older Chinese: thresholds for long and short forms. International Journal of Geriatric Psychiatry, 20, 465470.CrossRefGoogle Scholar
Chun, C. B., Kim, S. Y., Lee, J. Y. and Lee, S. Y. (2009). Republic of Korea: health system review. Health Systems in Transition, 11, 1184.Google Scholar
Feng, L., Yap, K. B., Kua, E. H. and Ng, T. P. (2009). Depressive symptoms, physician visits and hospitalization among community-dwelling older adults. International Psychogeriatrics, 21, 568575.CrossRefGoogle ScholarPubMed
Flett, G. L., Vredenburg, K. and Krames, L. (1997). The continuity of depression in clinical and nonclinical samples. Psychological Bulletin, 121, 395416.CrossRefGoogle ScholarPubMed
Friedman, B., Delavan, R. L., Sheeran, T. H. and Bruce, M. L. (2009). The effect of major and minor depression on Medicare home healthcare services use. Journal of the American Geriatrics Society, 57, 669675.CrossRefGoogle ScholarPubMed
Himelhoch, S., Weller, W. E., Wu, A. W., Anderson, G. F. and Cooper, L. A. (2004). Chronic medical illness, depression, and use of acute medical services among Medicare beneficiaries. Medical Care, 42, 512521.CrossRefGoogle ScholarPubMed
Irwin, M., Artin, K. H. and Oxman, M. N. (1999). Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Archives of Internal Medicine, 159, 17011704.CrossRefGoogle ScholarPubMed
Jang, S. N. et al. (2009). Employment status and depressive symptoms in Koreans: results from a baseline survey of the Korean Longitudinal Study of Aging. Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 64B, 677683.CrossRefGoogle Scholar
Jang, Y., Kim, G., Hansen, L. and Chiriboga, D. A. (2007). Attitudes of older Korean Americans toward mental health services. Journal of the American Geriatrics Society, 55, 616620.CrossRefGoogle ScholarPubMed
Kang, Y., Na, D. L. and Hahn, S. (1997). A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. Journal of the Korean Neurological Association, 15, 300308.Google Scholar
Katon, W. J., Lin, E., Russo, J. and Unutzer, J. (2003). Increased medical costs of a population-based sample of depressed elderly patients. Archives of General Psychiatry, 60, 897903.CrossRefGoogle ScholarPubMed
Kim, D. B. and Sohn, E. S. (2005). A meta-analysis of the variables related to depression in elderly. Journal of the Korean Gerontological Society, 25, 167187.Google Scholar
Kim, N. S., Kim, K. H., Lee, S. M., Paek, J. W. and Lee, B. R. (2008). Health Care Utilization and Quality of Care for Patients with Depression. Seoul: Health Insurance Review Agency.Google Scholar
Korea Labor Institute (2007). User Guide for 2006 Korean Longitudinal Study of Ageing. Seoul: Korea Labor Institute.Google Scholar
Korea Ministry of Health and Welfare (2009). An Overview of Chronic Disease Management Programs. Seoul: Korea Ministry of Health and Welfare.Google Scholar
Lee, S. J., Jung, K. H., Kang, E. J., Kang, S. K., Lee, S. H. and Kim, Y. A. (2009). Socio-economic Factors and Policy Implication of Elderly Suicide. Seoul: Korean Institute for Health and Social Affairs.Google Scholar
Luber, M. P. et al. (2001). Depression and service utilization in elderly primary care patients. American Journal of Geriatric Psychiatry, 9, 169176.CrossRefGoogle ScholarPubMed
McCabe, M. P., Davison, T., Mellor, D. and George, K. (2009). Barriers to care for depressed older people: perceptions of aged care among medical professionals. International Journal of Aging and Human Development, 68, 5364.CrossRefGoogle ScholarPubMed
McGrady, A., Lynch, D. J., Nagel, R. W. and Tamburrino, M. (2010). Coherence between physician diagnosis and patient self reports of anxiety and depression in primary care. Journal of Nervous and Mental Disease, 198, 420424.CrossRefGoogle ScholarPubMed
Murray, J., Banerjee, S., Byng, R., Tylee, A., Bhugra, D. and Macdonald, A. (2006). Primary care professionals’ perceptions of depression in older people: a qualitative study. Social Science and Medicine, 63, 13631373.CrossRefGoogle ScholarPubMed
OECD (2009). Society at a Glance 2009. Paris: Organisation for Economic Co-operation and Development.Google Scholar
Prisciandaro, J. J. and Roberts, J. E. (2009). A comparison of the predictive abilities of dimensional and categorical models of unipolar depression in the National Comorbidity Survey. Psychological Medicine, 39, 10871096.CrossRefGoogle ScholarPubMed
Son, E. J. (2002). Norms for the Korean Mini-Mental State Examination (K-MMSE) among rural community populations in Korea. Chonnam Medical Journal, 38, 1216.Google Scholar
Stein, M. B., Cox, B. J., Afifi, T. O., Belik, S. L. and Sareen, J. (2006). Does co-morbid depressive illness magnify the impact of chronic physical illness? A population-based perspective. Psychological Medicine, 36, 587596.CrossRefGoogle ScholarPubMed
Won, C. W., Rho, Y. G., Kim, S. Y., Cho, B. R. and Lee, Y. S. (2002). The validity and reliability of Korean Activities of Daily Living (K-ADL) scale. Journal of the Korean Geriatrics Society, 6, 98106.Google Scholar
Wong, S. Y., Mercer, S. M., Leung, J. and Woo, J. (2009). The relationship between clinically relevant depressive symptoms and episodes and duration of all cause hospitalization in Southern Chinese elderly. Journal of Affective Disorders, 113, 272278.CrossRefGoogle ScholarPubMed
World Health Organization (2010). Depression. Available at: http://www.who.int/mental_health/management/depression/definition/en/; last accessed 15 December 2010.Google Scholar