Document Detail


Geographic variation in poststroke depression among veterans with acute stroke.
MedLine Citation:
PMID:  19165692     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study compared patterns of poststroke depression (PSD) detection among veterans with acute stroke in eight U.S. geographic regions. Department of Veterans Affairs (VA) medical and pharmacy data as well as Medicare data were used. International Classification of Diseases-9th Revision depression codes and antidepressant medication dispensing were applied to define patients' PSD status 12 months poststroke. Logistic regression models were fit to compare VA PSD diagnosis and overall PSD detection between the regions. The use of VA medical data alone may underestimate the rate of PSD. Geographic variation in PSD detection depended on the data used. If VA medical data alone were used, we found no significant variation. If VA medical data were used along with Medicare and VA pharmacy data, we observed a significant variation in overall PSD detection across the regions after adjusting for potential risk factors. VA clinicians and policy makers need to consider enrollees' use of services outside the system when conducting program evaluation. Future research on PSD among veteran patients should use VA medical data in combination with Medicare and VA pharmacy data to obtain a comprehensive understanding of patients' PSD.
Authors:
Huanguang Jia; L Douglas Ried; Xinping Wang; Teresa M Damush; Linda J Young; Randi H Cameon; Linda S Williams
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of rehabilitation research and development     Volume:  45     ISSN:  1938-1352     ISO Abbreviation:  J Rehabil Res Dev     Publication Date:  2008  
Date Detail:
Created Date:  2009-01-23     Completed Date:  2009-05-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8410047     Medline TA:  J Rehabil Res Dev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1027-35     Citation Subset:  IM    
Affiliation:
Department of Veterans Affairs (VA) Stroke Quality Enhancement Research Initiative (QUERI) and VA Rehabilitation Outcomes Research Center Research Enhancement Award Program, Gainesville, FL, USA. Huanguang.Jia@med.va.gov
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cluster Analysis
Cross-Sectional Studies
Databases, Factual
Depression / epidemiology*,  etiology*
Female
Health Status Disparities*
Humans
Male
Middle Aged
Odds Ratio
Prevalence
Stroke / psychology*,  rehabilitation
United States / epidemiology
Veterans

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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