relationship between depressive symptom severity and emergency department use among low-income, depressed homebound older adults aged 50 years and older抑郁症状严重程度之间的关系和急诊室使用低收入,沮丧的回家的年龄在50岁及以上的老年人.pdfVIP

Choi et al. BMC Psychiatry 2012, 12:233 /1471-244X/12/233 RESEARCH ARTICLE Open Access Relationship between depressive symptom severity and emergency department use among low-income, depressed homebound older adults aged 50 years and older 1* 1 2 3,4,5 Namkee G Choi , C Nathan Marti , Martha L Bruce and Mark E Kunik Abstract Background: Previous research found a high prevalence of depression, along with chronic illnesses and disabilities, among older ED patients. This study examined the relationship between depressive symptom severity and the number of ED visits among low-income homebound older adults who participated in a randomized controlled trial of telehealth problem-solving therapy (PST). Methods: The number of and reasons for ED visits were collected from the study participants (n=121 at baseline) at all assessment points—baseline and 12- and 24-week follow-ups. Depressive symptoms were measured with the 24-item Hamilton Rating Scale for Depression (HAMD). All multivariable analyses examining the relationships between ED visits and depressive symptoms were conducted using zero-inflated Poisson regression models. Results: Of the participants, 67.7% used the ED at least once and 61% of the visitors made at least one return visit during the approximately 12-month period. Body pain (not from fall injury and not including chest pain) was the most common reason. The ED visit frequency at baseline and at follow-up was significantly positively associated with the HAMD scores at the assessment points. The ED visit frequency at follow-up, controlling for the ED visits at baseline, was also significantly associated with the HAMD score change since baseline. Conclusions: The ED visit rate was much higher than those reported