Depression, chronic obstructive pulmonary disease, and healthcare utilization: Results from the Korean Longitudinal Study of Aging (KLoSA)

Abstract

bstract Background Depression is a common comorbidity among people with chronic obstructive pulmonary disease (COPD), but the health effects of depression in this group of patients remain poorly understood. The purpose of the present study was to investigate the association between COPD and depression, and the effects of comorbid COPD and depression on health care utilization. Methods Our study sample included 10,180 Korean adults (4,437 men and 5,743 women; all aged ≥ 45 years) who participated in the cross‐sectional Korean Longitudinal Study of Aging (KLoSA). The participants were required to self‐report any previous diagnosis of COPD. Depression was assessed with the 10‐item Center for Epidemiologic Studies Depression Scale (CES‐D10). Health care utilization was defined as multiple physician visits (≥6) and multiple hospital admissions (≥2) in the previous year. Results Participants with COPD had a higher prevalence of depression than those without COPD (16.8% vs. 38.1%, respectively; P < 0.001). After adjustment for covariates, participants with COPD had a significantly higher likelihood of multiple physician visits (odds ratio [OR], 95% confidence interval [CI], 1.80 [1.26‐2.58]) and multiple hospital admissions (OR [95% CI], 1.62 [1.04‐3.51]), while those with COPD plus depression had a higher likelihood of multiple hospital admissions (OR [95% CI], 2.71 [2.34‐5.48]). Conclusions We found a positive association between COPD and depression. Depression in patients with COPD is associated with an increased likelihood of multiple hospital admissions.