Rural-Urban Differences in Depression Treatment and Suicidality

Bibliographic Data

ID9102342
AuthorsKathryn Rost (The Centers, corresponding author), Mingliang Zhang (0000-0002-6421-7730, University of Arkansas for Medical Sciences), John C Fortney (0000-0001-9409-8894, University of Arkansas for Medical Sciences), John Fortney, Jeff Smith (0000-0002-4409-2504), Jeffrey L Smith (0000-0001-7766-3118, University of Arkansas for Medical Sciences), Glen Smith (0000-0002-7594-4386, University of Arkansas for Medical Sciences), G RICHARD SMITH
Year1998
Volume36
Issue7
Pages1098-1107
Publication date1998-07-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199807000-00015
PMID9674626
OpenAlexW2122907283
LanguageEN
Citations received34
References cited24

OBJECTIVES: Because there are fewer per capita providers trained to deliver mental health services in rural areas, the authors hypothesized that depressed rural individuals would receive less outpatient treatment and report higher rates of hospital admittance and suicide attempts than their urban counterparts. METHODS: The authors recruited 74% of eligible participants (n = 470) from a 1992 telephone survey and followed up 95% of subjects for 1 year. The authors collected data from subjects on psychiatric problems and service use and from insurers/providers on treatment and expenditures. RESULTS: Although there were no rural-urban differences in the rate, type, or quality of outpatient depression treatment, rural subjects made significantly fewer specialty care visits for depression. Depressed rural individuals had 3.05 times the odds of being admitted to the hospital for physical problems (P = 0.02) and 3.06 times the odds of being admitted for mental health problems (P = 0.08) during the year. Elevated rates of hospital admittance disappear in models controlling for number of specialty care depression visits in the previous month. Rural subjects reported significantly more suicide attempts during the period of 1 year (P = 0.05). CONCLUSIONS: Additional work is warranted to determine how to alter barriers to outpatient specialty care if the rural health care delivery system is to provide cost-effective depression care

Depression (economics) · Family medicine · Health care · Logistic regression · Mental health · Occupational safety and health · Odds · Odds ratio · Poison control · Psychiatry · Rural area · Specialty · Suicide prevention · Emergency Medicine · Global Health Workforce Issues · Internal Medicine · Medicine · Mental Health Treatment and Access · Primary Care and Health Outcomes