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Patterns of Care for Depressed Older Adults in a Large-Staff Model HMO

Received April 10, 1998; revised August 22, 1998; accepted October 2, 1998. From the Center for Health Services Research, UCLA Neuropsychiatric Institute, Los Angeles, CA. Address correspondence to Dr. Unützer, UCLA Neuropsychiatric Institute, 10920 Wilshire Boulevard, Suite 300, Los Angeles, CA 90024-6505. e-mail: unutzer{at}ucla edu

The authors examined automated pharmacy and visit data for 502 members of a large-staff model health maintenance organization (HMO) who had been diagnosed with depression and started on antidepressants by their primary-care providers. Older patients (age 60; n=110) were less likely than younger adults (age 18–59, n=110) to receive adequate doses of antidepressant medications for 30 or 90 days. Older adults were also less likely than younger adults to receive more than two primary-care visits for depression in the 12 weeks after receiving a new antidepressant prescription and were less likely to receive specialty mental health care in the 6 months after receiving a new antidepressant prescription.

Key Words: Health Services • Primary Care • Depression

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