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Impact of Depressive Disorder on Access and Quality of Care in Veterans With Prevalent Cardiovascular Disease.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2018 Jun 15; Vol. 121 (12), pp. 1629-1633. Date of Electronic Publication: 2018 Mar 14. - Publication Year :
- 2018
-
Abstract
- Although depressive disorders have been associated with increased risk of worse outcomes with cardiovascular diseases (CVDs), its relation with access to and quality of cardiovascular care is not well studied. Accordingly, we sought to assess the association between depressive disorders and access and quality of care among United States veterans with CVD. The 2013 Centers for Disease Control's Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of 13,126 veterans with CVD. Demographic and clinical history were recorded in adults with and without a depressive disorder (defined as self-reported diagnosis of depression, major depression, minor depression, or dysthymia). Among 13,126 veterans studied, a total of 2,889 (22.0%) adults had a depressive disorder whereas 10,237 (78.0%) did not. The veterans with a depressive disorder were younger, more often female and non-white, and had higher rates of multiple medical co-morbidities. They were more likely to report a delay in receiving medical care and financial barriers to seeking care and taking prescription drugs. They also reported significantly lower rates of aspirin and antihypertensive drug use. In multivariate analysis, depressive disorder was independently associated with higher risk of delay in receiving medical care (OR [odds ratio] 2.07, 95% CI [confidence interval] 1.65 to 2.60), financial barriers to medical care (OR 1.96, 95% CI 1.45 to 2.65), and prescription drugs (OR 1.45, 95% CI 1.02 to 2.08). In conclusion, depressive disorders were associated with impaired access to care among United States veterans with CVD.<br /> (Published by Elsevier Inc.)
- Subjects :
- Age Distribution
Aged
Angina Pectoris epidemiology
Angina Pectoris therapy
Antihypertensive Agents therapeutic use
Aspirin therapeutic use
Cardiovascular Diseases therapy
Cohort Studies
Coronary Artery Disease epidemiology
Coronary Artery Disease therapy
Depressive Disorder, Major epidemiology
Dysthymic Disorder epidemiology
Economic Status
Female
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction epidemiology
Myocardial Infarction therapy
Odds Ratio
Platelet Aggregation Inhibitors therapeutic use
Prevalence
Quality Indicators, Health Care
Self Report
Sex Distribution
Stroke epidemiology
Stroke therapy
Time Factors
United States epidemiology
Cardiovascular Diseases epidemiology
Depressive Disorder epidemiology
Health Services Accessibility statistics & numerical data
Quality of Health Care
Veterans statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 121
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 29606323
- Full Text :
- https://doi.org/10.1016/j.amjcard.2018.02.048