Address correspondence to Steven C. Martino, Ph.D.; RAND, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213 2665; e-mail: firstname.lastname@example.org. Marc N. Elliott, Ph.D., David E. Kanouse, Ph.D. and Q Burkhart, Ph.D., are with the RAND, Santa Monica, CA. Donna O. Farley, Ph.D., is with the RAND, Pittsburgh, PA. Ron D. Hays, Ph.D., is with the Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA.
Depression and the Health Care Experiences of Medicare Beneficiaries
Article first published online: 15 JUL 2011
© Health Research and Educational Trust
Health Services Research
Volume 46, Issue 6pt1, pages 1883–1904, December 2011
How to Cite
Martino, S. C., Elliott, M. N., Kanouse, D. E., Farley, D. O., Burkhart, Q. and Hays, R. D. (2011), Depression and the Health Care Experiences of Medicare Beneficiaries. Health Services Research, 46: 1883–1904. doi: 10.1111/j.1475-6773.2011.01293.x
- Issue published online: 16 NOV 2011
- Article first published online: 15 JUL 2011
- Medicare population;
- patient confidence;
- patient experience
Objectives. To compare health care experiences of Medicare beneficiaries with and without symptoms of depression and investigate the role of patient confidence in shaping these experiences.
Data Sources. Data came from the 2009 CAHPS Medicare 4.0 Fee-for-Service (FFS) Survey, which was fielded to a national probability sample of 298,492 FFS Medicare beneficiaries.
Study Design. Linear regression was used to model associations of depression with four global ratings and three composite measures of health care and to test whether beneficiaries' confidence in their ability to recognize the need for care mediates these associations.
Principal Findings. Beneficiaries with depressive symptoms reported worse experiences with care across the full range of patient experience covered by the CAHPS survey. Depressive symptoms were associated with decreased patient confidence and decreased confidence was in turn associated with poorer reports of care.
Conclusions. Our study highlights depressive symptoms as a risk factor for poorer experiences of health care and highlights depressed patients' confidence in recognizing their need for care and for designing programs to improve the health care of this population.