Cross-Sectional Associations of Depressive Symptom Severity and Functioning with Health Service Use by Older XXXX in Low-and-Middle Income Countries.

@entity1 @entity308 @entity303 @entity7634
BACKGROUND: Comprehensive understanding of the determinants of health service use (HSU) by older @entity1 with @entity308 is essential for health service planning for an ageing global population. This study aimed to determine the extent to which depressive symptom severity and functioning are associated with HSU by older @entity1 with @entity308 in low and middle income countries (LMICs). METHODS: A cross-sectional analysis of the 10/66 @entity303 Research Group population-based surveys dataset. @entity1 (n = 4590) were those aged 65 or older, in the clinical range for @entity308 (defined as scoring four or more on the @entity7634 -D), living in 13 urban and/or rural catchment areas in nine LMICs. Associations were calculated using Poisson regression and random-effects meta-analysis. RESULTS: After adjustment for confounding variables, ( @entity7634 -D) depressive symptom severity was significantly associated with "any community HSU" (Pooled Prevalence Ratios = 1.02; 95% CI = 1.01-1.03) but not hospital admission. Conversely, after adjustment, (WHODAS-II) functioning was significantly associated with hospital admission (Pooled PR = 1.14; 95% CI = 1.02-1.26) but not "any community HSU". CONCLUSIONS: Depressive symptom severity does not explain a large proportion of the variance in HSU by older @entity1 with @entity308 in LMICs. The association of functioning with this HSU is worthy of further investigation. In LMICs, variables related to accessibility may be more important correlates of HSU than variables directly related to health problems.
