Prior Depression and Health Insurance in Non-receipt of Needed Medical Services.

Abstract

Rates of non-access to needed medical services are elevated among uninsured and sociodemographic subpopulations. Clinical depression is associated with comorbid medical illness and reduced treatment adherence. The purpose of this study was to examine whether prior depression predicts missed needed medical care independent of health insurance status and socioeconomic and demographic characteristics. Data were from a cross-sectional representative sample of adult New York City residents, surveyed through the 2009 (n=9,900) and 2010 (n=8,622) annual Community Health Survey. Logistic regression was used to evaluate the association of lifetime depression with missed needed medical care in the past year, with stratification by health insurance status and adjustment for socioeconomic characteristics. Analyses were performed in 2014. Prior depression was associated with missed needed medical care among both insured (OR=1.9, 95% CI=1.7, 2.2) and uninsured adults (OR=1.8, 95% CI=1.3, 2.4). Missed needed care report was associated with uninsured status (OR=3.6, 95% CI=3.1, 4.0), controlling for employment, income, and demographics. Prior depression corresponded to greater probability of missed needed medical care report in the previous year, independent of health insurance status, employment, income, and demographics.