Date of Award

1-1-2019

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Josephine Hoh

Abstract

Serious psychological distress (SPD) can adversely impact health and quality of life for people with atherosclerotic cardiovascular disease (ASCVD). The purpose of this study is to examine the association between SPD and the use of medical expenditure and utilization among people with and without ASCVD. A total of 18770 adults with ASCVD and 2083 adults without ASCVD as comparison group were identified from the population-based Medical Expenditure Panel Survey (2015). SPD was assessed using 6-item Kessler Psychological Distress Scale. We examined the use of medical expenditure and utilization in ASCVD patients and comparison adults with/without SPD. Two-part econometric models analyzed cost data. Multivariable logistic regression models were conducted for utilization adjusting for demographic and usual source of care covariates. Adjusted odds ratios and 95% confidence intervals were calculated. Prevalence of SPD was 9.91% in ASCVD patients compared to 3.51% in comparison adults. ASCVD patients with SPD have higher medical expenditure and utilization. Among people with ASCVD, the adjusted mean annual cost for those with and without SPD were $25,193.27 and $15,122.11. Among people without ASCVD, the adjusted mean annual cost for those with and without SPD were $10,975.11 and $4,876.36. Better coordination of care and patient-physician discussions are likely needed to improve delivery of medical services for persons with SPD.

Comments

This is an Open Access Thesis.

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