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Major depression and alcohol comorbi...

Brandeis University, The Heller School for Social Policy and Management.

Major depression and alcohol comorbidity in an elderly population: Access, outcomes, and services use.

紀錄類型:	書目-電子資源 : 單行本
正題名/作者:	Major depression and alcohol comorbidity in an elderly population: Access, outcomes, and services use./
作者:	Grantham, Susan M.
面頁冊數:	104 p.
附註:	Source: Dissertation Abstracts International, Volume: 68-03, Section: A, page: 1153.
Contained By:	Dissertation Abstracts International68-03A.
標題:	Gerontology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=3258680

Major depression and alcohol comorbidity in an elderly population: Access, outcomes, and services use.
Grantham, Susan M.

Major depression and alcohol comorbidity in an elderly population: Access, outcomes, and services use. - 104 p.

Source: Dissertation Abstracts International, Volume: 68-03, Section: A, page: 1153.

Thesis (Ph.D.)--Brandeis University, The Heller School for Social Policy and Management, 2007.

Between 8 and 20 percent of the elderly population is affected by depression. Despite a high level of need, few engage in mental health treatment. Those with depression or depressive symptomatology consume a disproportionately large share of health care resources.Subjects--Topical Terms:

168436
Gerontology.

Major depression and alcohol comorbidity in an elderly population: Access, outcomes, and services use.
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245 1 0 $a Major depression and alcohol comorbidity in an elderly population: Access, outcomes, and services use.
300 $a 104 p.
500 $a Source: Dissertation Abstracts International, Volume: 68-03, Section: A, page: 1153.
500 $a Adviser: Christopher Tompkins.
502 $a Thesis (Ph.D.)--Brandeis University, The Heller School for Social Policy and Management, 2007.
520 $a Between 8 and 20 percent of the elderly population is affected by depression. Despite a high level of need, few engage in mental health treatment. Those with depression or depressive symptomatology consume a disproportionately large share of health care resources.
520 $a Drawing upon a sample of 593 elderly primary care patients who assessed positive for major depression, a subset of the Primary Care Referral and Integrated Services for Substance Abuse and Mental Health for the Elderly (PRISM-E) study, this research addresses three related components: (1) factors related to mental health services utilization, including a characterization of the mental health care received; (2) factors related to depression remission; and (3) remission as a predictor of health services utilization offset. All three components of the study include an assessment of the influence of depression history and alcohol consumption.
520 $a The research is guided by Verbrugge and Jette's Disablement Process conceptual model and Andersen's Behavioral Model of Health Services Use. PRISM-E data are linked with Medicare claims and Veterans' Affairs outpatient data to assess utilization. Logistic regression modeling is used for components one and two, and a general estimating equations linear model approach is used for component three.
520 $a The results show that co-locating mental health specialists in primary care increased the odds of using mental health services. Neither use nor adequacy of mental health services predicted remission from depression. Remission predicted a reduction in mental health services use but no other category of ambulatory services. Prior utilization predicted use across all services, and physical functioning predicted use across all services except mental health.
520 $a Future research should focus on translating clinical research (i.e., efficacy studies) to practice settings, improving readiness of patients to accept treatment, and further understanding of various collaborative primary care/mental health models. Although remission may not result in reduced utilization, improved physical functioning (lessened disability) may be another pathway to a utilization offset. Future research may find, however, that improving depression outcomes and/or related disability may result in increased health services use in that patients may achieve improved capacity and motivation to seek services.
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791 $a Ph.D.
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