OBJECTIVES: To develop nationally representative estimates
of rates of diagnosis of depression; to determine rates
and type of treatment received by those diagnosed with
depression; and to ascertain socioeconomic differences and
trends in treatment rates of depression, including the effect
of supplemental insurance coverage, for elderly Medicare
fee-for-service beneficiaries.
DESIGN: Analysis of merged interview and Medicare
claims data for multiple years from merged Medicare
claims and interview data from the Medicare Current
Beneficiary Survey (MCBS), a nationally representative
survey of Medicare participants.
SETTING: Community dwellers.
PARTICIPANTS: Twenty thousand nine hundred sixty-six
community-dwelling respondents aged 65 and older in the
MCBS cost and use files for 1992 through 1998.
MEASUREMENTS: Diagnoses recorded in Medicare
claims were used to identify individuals who received a
diagnosis of depression from a healthcare provider;
pharmacy and claims data were used to identify receipt of
antidepressants and psychotherapy by those diagnosed.
RESULTS: The rate of depression diagnosis more than
doubled, reaching 5.8% in 1998. Overall, about two-thirds
of those diagnosed received treatment in each year; but
those aged 75 and older, those of ‘‘Hispanic or other’’
ethnicity, and those without additional coverage to supplement
Medicare were significantly less likely to receive
treatment, controlling for other characteristics. If treated,
members of these disadvantaged subgroups were less likely
to receive psychotherapy.
CONCLUSION: Although depression has been thought
until recent years to be underrecognized in the elderly, rates
of diagnosis increased dramatically in the 1990s, with