Access to Adequate Outpatient Depression Care for Mothers in the USA: A Nationally Representative Population-Based Study

The Journal of Behavioral Health Services & Research (Impact Factor: 1.03). 01/2010; 38(2):191-204. DOI: 10.1007/s11414-009-9194-y

ABSTRACT Maternal depression is often untreated, resulting in serious consequences for mothers and their children. Factors associated
with receipt of adequate treatment for depression were examined in a population-based sample of 2,130 mothers in the USA with
depression using data from the 1996–2005 Medical Expenditure Panel Survey. Chi-squared analyses were used to evaluate differences
in sociodemographic and health characteristics by maternal depression treatment status (none, some, and adequate). Multivariate
regression was used to model the odds of receiving some or adequate treatment, compared to none. Results indicated that only
34.8% of mothers in the USA with depression received adequate treatment. Mothers not in the paid workforce and those with
health insurance were more likely to receive treatment, while minority mothers and those with less education were less likely
to receive treatment. Understanding disparities in receipt of adequate treatment is critical to designing effective interventions,
reducing treatment inequities, and ultimately improving the mental health and health of mothers and their families.

Keywordsmaternal depression–access to treatment for depression–adequacy of treatment for depression–disparities in treatment for depression–population-based study–Medical Expenditure Panel Survey (MEPS)

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    ABSTRACT: Many women with depression are untreated or undertreated for their condition. The quality of patient-provider communication may impact the receipt of depression treatment. We examine the relationship between patient-provider communication and receipt of adequate treatment for depression among women. The study sample consisted of women with depression who visited a provider in the previous 12 months in the 2002-2008 Medical Expenditure Panel Survey (N = 3,179). Multivariate regression was used to examine the independent contribution of sociodemographic characteristics, health care factors, patient-provider communication, and respondent language on depression treatment status (none, some, adequate). We found that more than one-third of women with depression in the United States did not receive adequate treatment. Women reporting that providers usually or always listened carefully were more likely to receive adequate treatment (OR = 1.59; 95% CI = 1.10-2.30 and OR = 1.55; 95% CI = 1.07-2.23, respectively). Non-English-speaking women were 50% less likely to receive adequate treatment (OR = 0.49; 95% CI = 0.30-0.80). Having a usual source of care was associated with an increased likelihood of receiving some and adequate treatment (OR = 1.84; 95% CI = 1.24-2.73 and OR = 2.22; 95% CI = 1.61-3.05, respectively). Effective provider listening behaviors may help increase the number of U.S. women with depression who receive adequate treatment. Efforts to improve language access for limited English-proficient women are likely critical for improving treatment outcomes in this population. Additionally, ensuring that women with depression have consistent access to health care services is important for obtaining adequate depression care.
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