Depression and ambulatory care sensitive hospitalizations among Medicare beneficiaries with chronic physical conditions

Rituparna Bhattacharya, Chan Shen, Usha Sambamoorthi

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Objective: We examined the association between depression and hospitalizations for Ambulatory Care Sensitive Conditions (H-ACSC) among Medicare beneficiaries with chronic physical conditions. Methods: We used a retrospective longitudinal design using multiple years (2002-2009) of linked fee-for-service Medicare claims and survey data from Medicare Current Beneficiary Survey to create six longitudinal panels. We followed individuals in each panel for a period of 3-years; first year served as the baseline and subsequent 2-years served as the follow-up. We measured depression, chronic physical conditions and other characteristics at baseline and examined H-ACSC at follow-up. We identified chronic physical conditions from survey data and H-ACSC and depression from fee-for-service Medicare claims. We analyzed unadjusted and adjusted relationships between depression and the risk of H-ACSC with chi-square tests and logistic regressions. Results: Among all Medicare beneficiaries, 9.3% had diagnosed depression. Medicare beneficiaries with depression had higher rates of any H-ACSC as compared to those without depression (13.6% vs. 7.7%). Multivariable regression indicated that, compared to those without depression, Medicare beneficiaries with depression were more likely to experience any H-ACSC. Conclusions: Depression was associated with greater risk of H-ACSC, suggesting that health care quality measures may need to include depression as a risk-adjustment variable.

Original languageEnglish
Pages (from-to)460-465
Number of pages6
JournalGeneral Hospital Psychiatry
Volume36
Issue number5
DOIs
StatePublished - Sep 2014

Keywords

  • Ambulatory care sensitive conditions
  • Depression
  • Medicare
  • Preventable hospitalizations

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