Does diabetes double the risk of depression?

Purpose: In this study, we compared the rate of depression diagnoses in adults with and without diabetes mellitus, while carefully controlling for number of primary care visits.

Methods: We matched adults with incident diabetes (n = 2,932) or prevalent diabetes (n = 14,144) to nondiabetic control patients based on (1) age and sex, or (2) age, sex, and number of outpatient primary care visits. Logistic regression analysis was used to assess the association between various predictors and a diagnosis of depression in each diabetes cohort relative to matched nondiabetic control patients.

Managing fecal incontinence: self-care practices of older adults.

Little is known about the ways in which community-dwelling elderly individuals manage fecal incontinence (FI) in their daily lives. In this study, community-dwelling elderly individuals were surveyed at clinics of a health maintenance organization (HMO) to describe the self-care practices used to manage FI and to examine factors that influenced the number of self-care practices used and the reporting of FI to a health care practitioner. Responses of 242 elderly individuals who reported that they had FI several times per year were analyzed.

Severity of fecal incontinence in community-living elderly in a health maintenance organization.

An anonymous survey containing questions about the severity of fecal incontinence (FI)--frequency, amount, and type--and its correlates was distributed to community-living elderly at four managed-care clinics. Completed surveys were received from 1,352 respondents whose mean (+/-standard deviation) age was 75 +/- 6 years and 60% of whom were female. Approximately 19% reported having FI one or more times within the past year.

Treatment of elderly and other adult patients for depression in primary care.

Objectives: To determine whether depression is treated differently in older and younger patients in primary care clinics.

Design: Administrative data were used to identify patients with a depression diagnosis code. The sources of data were baseline and 3-month follow-up surveys, the health plan electronic database, and chart audits.

Community-based care and risk of nursing home placement.

Objective: To test the substitution hypothesis, that community-based care reduces the probability of institutional placement for at-risk elderly.

Research Design: The closure of the Social Health Maintenance Organization (Social HMO) at HealthPartners (HP) in Minnesota in 1994 and the continuation of the Social HMO at Kaiser Permanente Northwest (KPNW) in Oregon/Washington comprised a "natural experiment." Using multinomial logistic regression analyses, we followed cohorts of Social HMO enrollees for up to 5 years, 1995 to 1999.

When depression is the diagnosis, what happens to patients and are they satisfied?

Objectives: To understand the process, outcomes, and patient satisfaction of usual primary care for patients given a diagnostic code for depression.

Study Design: Health plan data were used to identify patients with a diagnostic code for depression (and no such diagnosis in the preceding 6 months). Patients were surveyed by mail soon after the coded visit and again 3 months later about the care they had received; their charts were also audited.

Geriatric depression, antidepressant treatment, and healthcare utilization in a health maintenance organization.

Objectives: To assess the separate effects of depressive symptoms and antidepressant treatment on healthcare utilization and cost.

Setting: Social Health Maintenance Organization (HMO) at HealthPartners in Minnesota.

Participants: Geriatric Social HMO enrollees were screened for depressive symptoms using the 30-item Geriatric Depression Scale.

Pharmaceutical care and health care utilization in an HMO.

Context: The belief that expanding the role of pharmacists in patient care could improve the safety and efficacy of drug therapy is growing. Specifically, pharmaceutical care programs through which pharmacists provide direct and ongoing counseling to patients have been introduced. Whether such programs reduce medication-related problems or health care utilization is unknown.