Major depression and emergency medical services utilization in community-dwelling elderly persons with disabilities.
Major depression and emergency medical services utilization in community-dwelling elderly persons with disabilities.
复制标题
社区残疾老年人重度抑郁症与紧急医疗服务利用情况。
DOI：
10.1002/gps.2063
复制
发表时间：
2008
影响因子：
4
通讯作者：
Friedman,Bruce
中科院分区：
文献类型：
--
作者：
Lee,BenjaminW;Conwell,Yeates;Shah,ManishN;Barker,WilliamH;Delavan,RachelL;Friedman,Bruce
ObjectiveStudy the association between major depression and emergency medical services（EMS）use by community‐dwelling elderly adults with disabilities.MethodsA prospective observational.study including 1，444 participants age 65+ in 19 counties in three US states that participated in the Medicare Primary and Consumer‐Directed Care Demonstration.合格标准包括需要或接受2+日常生活活动（ADL）或3+工具性ADL的帮助，以及最近接受过重要的医疗保健服务。在基线时通过MINI重度抑郁发作模块测量重度抑郁的存在。EMS利用率数据为未来2年，同时完成每个主题或career.ResultsMore的人与抑郁症（43%）比没有（35%）报告EMS使用的日报。当在逻辑回归模型中控制其他因素时，这种影响不再具有统计学意义。然而，在那些至少有一次EMS转运的患者中，抑郁症患者报告的事件（平均值= 2.10）比非抑郁症患者（平均值= 1.68）多得多（25%）。在Poisson（Z= 1.99;p= 0.047）和普通最小二乘（t= 2.08;p= 0.038）回归models.ConclusionsDepressed残疾老年人谁利用EMS有更多的EMS发作比那些没有抑郁症的EMS发作。这种更高的使用率可能部分是由情感疾病驱动的。需要研究来确定是否需要更多的EMS事件来解决重度抑郁症的症状，特别是自杀意念，或者它们是否是由于重度抑郁症症状加剧的其他疾病。版权所有© 2008约翰威利父子有限公司.
ObjectiveTo examine the association between major depression and emergency medical services (EMS) use by community‐dwelling older adults with disabilities.MethodsA prospective observational.study including 1,444 participants age 65+ in 19 counties in three US states that participated in the Medicare Primary and Consumer‐Directed Care Demonstration. Eligibility criteria included needing or receiving help with either 2+ activities of daily living (ADLs) or 3+ instrumental ADLs, and having received recent significant healthcare services use. The presence of major depression was measured at baseline by the MINI Major Depressive Episode module. EMS utilization data for the following 2 years were obtained from a daily journal concurrently completed by each subject or a caregiver.ResultsMore persons with major depression (43%) than without (35%) reported EMS use. When other factors were controlled in a logistic regression model, this effect was no longer statistically significant. However, of those with at least one episode of EMS transport, the depressed reported significantly (25%) more episodes (mean = 2.10) than the non‐depressed (mean = 1.68). Major depression was significantly associated with more EMS episodes in both Poisson (Z= 1.99;p= 0.047) and ordinary least squares (t= 2.08;p= 0.038) regression models.ConclusionsDepressed disabled older adults who utilize EMS have more EMS episodes than those without depression. This higher use may be driven in part by affective illness. Research is needed to determine whether more EMS episodes are necessary to address symptoms of major depression, especially suicidal ideation, or whether they are due to other illnesses that are exacerbated by symptoms of major depression. Copyright © 2008 John Wiley & Sons, Ltd.