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Quality of Care for Depressed Elders in Post-Acute Care: Variations in Needs Met Through Services

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Abstract

This paper addresses quality of post-acute care for older adults going home after hospitalization for depression. Quality was conceptualized and assessed in terms of services received for four domains of need: psychiatric, medical, functional, and psychosocial. At discharge, needs for care was assessed using medical records, standardized instruments, and patient interviews; quality of care was assessed by whether or not needs were met by services through the first 6 weeks of post-acute care. Quality of care varied across type of need: psychiatric needs were most likely, and psychosocial needs were least likely, to be met. Urban elders received better psychiatric care than did rural elders. Elders in worse physical health received better medical and psychosocial care, but poorer psychiatric care. Elders with psychoses and living with others had better care for functional dependencies. The competing demands perspective suggests that medical illness may take priority over psychiatric care.

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Acknowledgments

The preparation of this article was supported by the Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University in St. Louis, through an award from the National Institute of Mental Health (#5R24MH50857-04).

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Authors and Affiliations

  1. George Warren Brown School of Social Work, Washington University, One Brookings Drive, St. Louis, MO, 63130, USA

    Enola Proctor PhD

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  1. Enola Proctor PhD
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  2. Nancy Morrow-Howell PhD
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  3. Mi Jin Lee MSW
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  4. Jessica Gledhill MSW
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  5. Wayne Blinne MA
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Correspondence to Enola Proctor PhD.

Additional information

Nancy Morrow-Howell, PhD, George Warren Brown School Social Work, Washington University, One Brookings Drive, St. Louis, MO 63130, USA.

Mi Jin Lee, MSW, George Warren Brown School Social Work, Washington University, One Brookings Drive, St. Louis, MO 63130, USA.

Jessica Gledhill, MSW, Family and Children Services, 650 South Peoria, Tulsa, OK 74120, USA.

Wayne Blinne, MA, George Warren Brown School Social Work, Washington University, One Brookings Drive, St. Louis, MO 63130, USA.

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Proctor, E., Morrow-Howell, N., Lee, M.J. et al. Quality of Care for Depressed Elders in Post-Acute Care: Variations in Needs Met Through Services. JBHSR 33, 127–141 (2006). https://doi.org/10.1007/s11414-006-9017-3

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