Service Use of Depressed Elders After Acute Care (Gero-Psych)

Principal Investigator: Nancy Morrow-Howell, PhD, Enola Proctor, PhD, Co-PIs
Funder: National Institute of Mental Health ( 5 R01 MH 56208)
Timeframe: Funded 09/96-04/02
Affiliation: Center for Mental Health Services Research (CMHSR)

Project Staff:
           Eugene Rubin, MD, PhD, Investigator
           Arlene Stiffman, PhD, Investigator
           Ed Spitznagel, PhD, Statistician
           Ed Greenberg, PhD, Statistician
           Peter Dore, Data Manager
Project Contact:        Nancy Morrow-Howell, PhD
                                   Office Phone: (314) 935-6762
                                   E-mail:  nancymh@wustl.edu

Project Update as of 03/07/2008
Stage: Project completed

Baseline Findings:

Description:
    This study addressed service use of depressed elders after acute psychiatric care.  Depressed elders are hospitalized for shorter periods and are discharged at higher levels of dependency to a community system of care. This project sampled 200 elderly hospitalized patients who were treated for depression and discharged home, using medical records and subject reports to examine post-discharge service use patterns and predict variations in outcomes of acute care.  Inadequate service after discharge may undermine the effective use of expensive inpatient treatment. This study addressed the following specific objectives: identifying factors related to service utilization of depressed elders after psychiatric hospitalization in four sectors of care (specialty mental health, general health, form aging, and informal services); assessing and identifying factors associated with service adequacy, operationalized as the extent to which needs for care are met, and testing the relationship between service utilization and service adequacy; and testing the impact of service utilization and service adequacy on outcomes.

Selected Presentations, Posters, and Related Activities

2006

Poster presented at the Tenth Annual Conference of the Society for Social Work and Research.. “The Quality of Medical Care as Measured by Service Fit Among the Depressed Elderly.”  San Antonio, Texas, January.

2005

Poster presented at the Ninth Annual Conference of the Society for Social Work and Research. “The Effects of Quality of Post-Acute Care on Six Weeks and Six Months Depression Outcomes of Older Adults.” Miami, Florida, January.

 

Paper presented at the Ninth Annual Conference of the Society for Social Work and Research. “Configuration of Services Used By Depressed Older Adults in the Six-Month Post-Acute Period.” Miami, Florida, January.

2004

Presented at the Conference on the Complexities of Co-Occurring Conditions. “Quality of post-acute care for comorbid medical and psychosocial conditions: Relationship with outcomes of depressed elders.”  Washington, D.C., June.

2003

Paper presented at the Seventh Annual Conference of the Society for Social Work and Research. “Predictors of depressed elders’ health-related quality of life six months post-discharge from acute psychiatric hospitalization.” Washington, D.C., January.

2002

Presented at the Fourth International Conference on Evaluation for Practice. “Evaluating quality of care for depressed elders.” Tampere, Finland, July.

Paper presented at the Sixth Annual Conference of the Society for Social Work and Research: Promoting evidence-based social work practice. “Needs met among depressed elders in post-acute care: Conceptualization, measurement, and analysis.” San Diego, CA, January.

2001

Paper presented at the Fifth Annual Conference of the Society for Social Work and Research. “Service use of depressed elders after acute care.” Atlanta, GA, January.

Paper presented at the Fifth Annual Conference of the Society for Social Work and Research. “Post-acute disposition of older adults hospitalized for depression.” Atlanta, GA, January.

Paper presented at the Fifth Annual Conference of the Society for Social Work and Research. “Measuring service utilization by depressed older adults: Comparing self-report and service records.” Atlanta, GA, January.

Paper presented at the Fifth Annual Conference of the Society for Social Work and Research. “Patterns of early disposition for elderly adults hospitalized with depression.” Atlanta, GA, January.

2000

Presentation at the Association for Health Services Research. “Medical, mental health, and social service use prior to geropsychiatric hospitalization.” Los Angeles, June.

Presentation at the Gerontological Society of America.  “Post-acute disposition of older adults hospitalized for depression.”  Washington, D.C., November.

1999

Presentation at the Third Annual Conference of the Society for Social Work and Research, “The measurement of mental health service use.”  Austin, Texas, January.

1998

Presentation at the Gerontological Society of America.  “Service needs of depressed older adults.”  Philadelphia, Pennsylvania, November.

Presentation at the International Conference on Mental Health Problems in the General Health Care Sector.  “Multiaxial assessment of depressed older adults.” Baltimore, Maryland, July.

Poster presentation, Twelfth International Conference on Mental Health Problems in the General Health Care Sector. “Comorbid medical conditions of depressed elders discharged home after acute psychiatric care.” Baltimore, MD, July.

Presentation at the Missouri Institute of Mental Health.  “Mental health service utilization by depressed elderly.”  St. Louis, Missouri, March.

1997

Presentation at the International Conference on Depression in Primary Care. “Informal care to older adults hospitalized for depression.”  Washington, D.C., September.

Presentation at the Eleventh International Conference on Mental Health Problems in the General Health Care Sector: Spotlight on the Elderly. National Institute of Mental Health  “Service use of depressed elders after psychiatric hospitalization: Types and sectors of care.” Washington DC, September.

Presentation at the Eleventh International Conference on Mental Health Problems in the General Health Care Sector: Spotlight on the Elderly. National Institute of Mental Health. “Informal caregiving to functionally dependent geropsychiatric patients.” Washington DC, September.

Presentation at the Washington University Alzheimer’s Disease Research Center.  “Service use of depressed elders after acute care:  Results of a pilot study.”  St. Louis, Missouri, May.

Presentation at One McKnight Place, a retirement community, as part of Washington University lecture series.  “Depression in older adults.”  St. Louis, Missouri, April.

1996

Paper presentation at the Gerontology Society of America.  “Post-Acute service use of depressed elders discharged home: Formal and informal service utilization.”  Washington, D.C., November. 

Presentation at the Missouri NASW Gerontological Unit Meeting.  “Issues in post-hospital care.” St. Louis, Missouri, August.

Presentation at the Washington University Alzheimer’s Disease Research Center.  “Discharge destinations of Medicare patients receiving discharge planning: Who goes where?”  St. Louis, Missouri, April.

Paper presentation at the American Society on Aging.  “Post-hospital service utilization of geropsychiatric patients.”  Anaheim, California, March.

In Press Papers

      Lee, M., Proctor, E. & Morrow-Howell, N. (In press). Quality of post-acute care and depression outcomes of depressed elders. Psychiatric Services.

Published Papers

Morrow-Howell, N., Proctor, E., Blinne, W., Rubin, E., Saunders, J. & Rozario, P. (2006). Post-acute dispositions of older adults hospitalized ford depression. Aging and Mental Health, 10, 352-361.

Choi, S., Morrow-Howell, N., & Proctor, E. (2006). Configuration of services used by depressed older adults. Aging and Mental Health, 10, 240-249.

      Li, H., Morrow-Howell, N., & Proctor, E. (2006). Contribution of secondary caregivers to adequacy of informal care and formal service use of the elderly.  Journal of Social Service Research, 33, 39-46.

Rozario, P. (2006).  Changes in the SF-12 among depressed elders six months after discharge from an Inpatient Geropsychiatric Unit. Quality of Life Research, 15, 755-759.

Proctor, E., Morrow-Howell, N., Lee, M., Gledhill, J., & Blinne, W. (2006). Quality of care for depressed elders in post-acute care: Variations in needs met through services. Journal of Behavioral Health Services and Research, 33(2), TBA.

Saunders, J., Morrow-Howell, M., Spitznagel, E., Dore, P., Proctor, E., & Pescarino, R. (2006). Imputing missing data: A comparison of methods for Social Work Researchers. Social Work Research, 30(1), 19-31.

Li, H., Proctor, E., & Morrow-Howell, N. (2005). Outpatient mental health service use by older adults after acute psychiatric hospitalization. Journal of Behavioral Health Services and Research, 32(1), 74-84.

Rozario, P., Morrow-Howell, N. & Proctor, E. (2004). Comparing the congruency of self report and provider records of depressed elders’ service use by provider type. Medical Care, 42(10), 952-959.

Proctor, E., Morrow-Howell, N., Doré, P., Wentz, J., Ruben, E., Thompson, S., & Li, H. (2003). Comorbid medical conditions among depressed elders discharged home after acute psychiatric care. American Journal of Geriatric Psychiatry, 11(3), 329-338.

Morrow-Howell, N., Proctor, E.K., Rubin, E., Li, H., & Thompson, S. (2000). Service needs of depressed older adults following acute psychiatric care. Aging and Mental Health, 4(4), 330-338.

Proctor, E.K., Morrow-Howell, N., Rubin, E., & Ringenberg, M. (1999). Service use of depressed elders after psychiatric hospitalization: Types and sectors of care. Psychiatric Services, 50(4), 553-555.

   Morrow-Howell, N. & Proctor, E.K. (1998). Informal caregiving to older adults hospitalized for depression. Aging & Mental Health, 2(3), 222-231.