Mónica Pérez Jolles1, Lindsey Haynes-Maslow, Megan C Roberts, Stacie B Dusetzina. 1. *Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC †Food Systems and Health Analyst/Food and Environment Program Union of Concerned Scientists, Washington, DC ‡Department of Health Policy and Management, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC §Cecil G. Sheps Center for Health Services Research ∥Department of Health Policy and Management, Gillings School of Global Public Health ¶Lineberger Comprehensive Cancer Center #Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract
BACKGROUND: Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. OBJECTIVES: Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. RESEARCH DESIGN: Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3000 physicians in office-based settings. SUBJECTS: Office visits from 2007 to 2010 were pooled for adults aged 35-85 with a depression diagnosis at the time of visit (N=3659 visits). MEASURES: Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. RESULTS: Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least 1 physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (P<0.05). There were no differences in service use by race/ethnicity after controlling for other factors. CONCLUSIONS: Additional research is needed on medical care delivery among patients with co-occurring health conditions, particularly as the health care system moves toward an integrated care model.
BACKGROUND: Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. OBJECTIVES: Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. RESEARCH DESIGN: Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3000 physicians in office-based settings. SUBJECTS: Office visits from 2007 to 2010 were pooled for adults aged 35-85 with a depression diagnosis at the time of visit (N=3659 visits). MEASURES: Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. RESULTS: Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least 1 physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (P<0.05). There were no differences in service use by race/ethnicity after controlling for other factors. CONCLUSIONS: Additional research is needed on medical care delivery among patients with co-occurring health conditions, particularly as the health care system moves toward an integrated care model.
Authors: Karen E Lasser; David U Himmelstein; Steffie J Woolhandler; Danny McCormick; David H Bor Journal: Int J Health Serv Date: 2002 Impact factor: 1.663
Authors: Tobias Gerhard; Ayse Akincigil; Christoph U Correll; Neil J Foglio; Stephen Crystal; Mark Olfson Journal: J Clin Psychiatry Date: 2014-05 Impact factor: 4.384
Authors: Barbara Starfield; Klaus W Lemke; Terence Bernhardt; Steven S Foldes; Christopher B Forrest; Jonathan P Weiner Journal: Ann Fam Med Date: 2003 May-Jun Impact factor: 5.166
Authors: Vanessa A Palzes; Sujaya Parthasarathy; Felicia W Chi; Andrea H Kline-Simon; Yun Lu; Constance Weisner; Thekla B Ross; Joseph Elson; Stacy A Sterling Journal: Alcohol Clin Exp Res Date: 2020-11-05 Impact factor: 3.455