PMID- 34626439
OWN - NLM
STAT- MEDLINE
DCOM- 20220110
LR  - 20220110
IS  - 1099-1166 (Electronic)
IS  - 0885-6230 (Linking)
VI  - 37
IP  - 1
DP  - 2022 Jan
TI  - Associations between depressive symptom clusters and care utilization and costs 
      among community-dwelling older adults.
LID - 10.1002/gps.5636 [doi]
AB  - OBJECTIVES: Whether and how symptom clusters are associated with care utilization 
      remains understudied. This study aims to investigate the economic impact of 
      symptom clusters. METHODS: We conducted cross-sectional analyses of data 
      collected from 3255 older adults aged 60 years and over in Hong Kong using the 
      Patient Health Questionnaire-9 and the Client Service Receipt Inventory to 
      measure depressive symptoms and service utilization to calculate 1-year care 
      expenditure. Based on Research Domain Criteria framework, we categorized 
      depressive symptoms into four clusters: Negative Valance Systems and 
      Externalizing (NVSE; anhedonia and depression), Negative Valance Systems and 
      Internalizing (guilt and self-harm), Arousal and Regulatory Systems (sleep, 
      fatigue, and appetite), and Cognitive and Sensorimotor Systems (CSS; 
      concentration and psychomotor). Two-part models were used with four symptom 
      clusters to estimate economic impacts on care utilization. RESULTS: Core 
      affective symptoms had the largest economic impact on non-psychiatric care 
      expenditure; a one-point increase in NVSE was associated with USD$ 571 additional 
      non-psychiatric care expenditure. The economic impacts of CSS on non-psychiatric 
      care expenditure was attenuated when the severity level of NVSE was higher. 
      CONCLUSIONS: Our findings highlight the importance of understanding economic 
      impacts on care utilization based on symptom profiles with a particular emphasis 
      on symptom combinations. Policymakers should optimize care allocation based on 
      older adults' depressive symptom profiles rather than simply considering their 
      depression sum-score or the severity defined by cut-off points.
CI  - (c) 2021 John Wiley & Sons Ltd.
FAU - Lu, Shiyu
AU  - Lu S
AUID- ORCID: 0000-0002-9355-4883
AD  - Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China.
AD  - Department of Social and Behavioural Sciences, City University of Hong Kong, Hong 
      Kong, China.
FAU - Zhang, Yan
AU  - Zhang Y
AD  - Department of Social Work and Social Administration, The University of Hong Kong, 
      Hong Kong, China.
FAU - Liu, Tianyin
AU  - Liu T
AUID- ORCID: 0000-0002-8194-5342
AD  - Department of Social Work and Social Administration, The University of Hong Kong, 
      Hong Kong, China.
FAU - Leung, Dara K Y
AU  - Leung DKY
AUID- ORCID: 0000-0002-7255-2790
AD  - Department of Social Work and Social Administration, The University of Hong Kong, 
      Hong Kong, China.
FAU - Kwok, Wai-Wai
AU  - Kwok WW
AD  - Department of Social Work and Social Administration, The University of Hong Kong, 
      Hong Kong, China.
FAU - Luo, Hao
AU  - Luo H
AD  - Department of Social Work and Social Administration, The University of Hong Kong, 
      Hong Kong, China.
FAU - Tang, Jennifer
AU  - Tang J
AD  - Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China.
FAU - Wong, Gloria H Y
AU  - Wong GHY
AUID- ORCID: 0000-0002-1331-942X
AD  - Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China.
AD  - Department of Social Work and Social Administration, The University of Hong Kong, 
      Hong Kong, China.
FAU - Lum, Terry Y S
AU  - Lum TYS
AUID- ORCID: 0000-0003-1196-5345
AD  - Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China.
AD  - Department of Social Work and Social Administration, The University of Hong Kong, 
      Hong Kong, China.
LA  - eng
PT  - Journal Article
DEP - 20211014
PL  - England
TA  - Int J Geriatr Psychiatry
JT  - International journal of geriatric psychiatry
JID - 8710629
SB  - IM
MH  - Aged
MH  - Cross-Sectional Studies
MH  - *Depression
MH  - Fatigue
MH  - Humans
MH  - *Independent Living
MH  - Middle Aged
MH  - Patient Health Questionnaire
OTO - NOTNLM
OT  - depression
OT  - health economics
OT  - health service research
OT  - mental health
EDAT- 2021/10/10 06:00
MHDA- 2022/01/11 06:00
CRDT- 2021/10/09 12:14
PHST- 2021/07/19 00:00 [received]
PHST- 2021/10/05 00:00 [accepted]
PHST- 2021/10/10 06:00 [pubmed]
PHST- 2022/01/11 06:00 [medline]
PHST- 2021/10/09 12:14 [entrez]
AID - 10.1002/gps.5636 [doi]
PST - ppublish
SO  - Int J Geriatr Psychiatry. 2022 Jan;37(1). doi: 10.1002/gps.5636. Epub 2021 Oct 
      14.