Effect of depression on health service utilisation in men: a prospective cohort study of Australian men aged 35 to 80 years. Issue 3 (17th March 2021)

• Record Type: Journal Article
• Authors: Martin, Sean; Zajac, Ian; Vincent, Andrew; Adams, Robert J; Appleton, Sarah; Wittert, Gary A
• Is Part Of: BMJ open. Volume 11:Issue 3(2021)
• Publication Date: 2021-03-17
• Subjects: public health -- epidemiology -- depression & mood disorders -- primary care; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-044893
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To examine the relationship between depression burden, health service utilisation and depression diagnosis in community-based men. Design: Prospective cohort study. Setting: Community-based. Participants: Men aged 35–80 years at recruitment (2002–2005), randomly selected from the northern and western suburbs of Adelaide, Australia, without depression at baseline, who attended follow-up visits (2007–2010) (n=1464). Primary and secondary outcome measures: Depression symptoms were categorised into high burden (total score of ≥13 for the Beck Depression Inventory (BDI) or ≥10 for the Centre for Epidemiologic Studies Depression Scale (CES-D) or low burden (<13 for the BDI or <10 for the CES-D). Diagnosed depression was determined by patient-reported physician diagnosis. Frequent general practitioner (GP) visits were those occurring 5+ times over the preceding year. Use of national medical and prescription services (Medicare Benefit Schedule and Pharmaceutical Benefit Scheme; MBS and PBS) was assessed through data linkage. Results: Frequent attendance and depression diagnosis was more common in men with a high than low burden of depression symptoms (45.9% vs 29.3%–18.7% vs 1.9%, p<0.001). Depression diagnoses were also more common in frequent GP attenders compared with low-average attenders (5.1% vs 2.2%, p<0.001). Among men with high burden of symptoms, there was no age-adjusted or multi-adjusted difference for likelihood of depression diagnosis between non-regular and frequent GP attenders. Annualised MBS and PBS expenditure was highest for men with undiagnosed depression. Conclusions: Men with a high burden of depression symptoms have commensurate use of health services when compared with those with a low burden, but only half report a physician diagnosis of depression. Undiagnosed depression led to a higher usage of medical and prescription services.