TABLE 1.

Characteristics Associated With Treatment Episodes for Elderly Medicare Beneficiaries With a Diagnosis of Depression, 1992–1999^a

Characteristic	All Treatment Episodes With a Diagnosis of Depression (N=2,025)		Treatment Episodes With Use of Psychotherapy (N=474) [25.2%]		Multiple Logistic Regression
	N	%	N	%	Odds Ratio	95% CI
Beneficiary characteristics
Gender
Female	1,499	73.3	341	24.2	1.03	0.68–1.54
Male	526	26.7	133	28.0	1.00	—
Race
White	1,777	89.6	418	25.7	1.00	—
Nonwhite	248	10.4	56	20.9	0.84	0.47–1.52
Age (years)b
65–74	842	49.4	243	29.5	1.00	—
≥75	1,183	50.6	231	21.0	0.68c	0.51–0.89
Educationb
College	166	9.1	68	47.2	2.72c	1.67–4.43
No college	1,845	90.9	402	23.0	1.00	—
Income-to-needs ratiob
<200%	1,252	57.9	256	21.3	0.94	0.67–1.32
≥200%	773	42.1	218	30.6	1.00	—
Living arrangementb
Alone	779	36.6	151	22.0	1.00	—
With spouse	849	45.2	235	29.2	1.38d	0.99–1.92
With other(s)	397	18.2	88	21.8	1.16	0.77–1.74
County of residenceb,e
Metropolitan	1,405	71.8	396	30.2	—	—
Nonmetropolitan	620	28.2	78	12.6	—	—
Supplemental insurance coveragef
Yes	1,930	95.5	457	25.6	1.35	0.68–2.66
No	95	4.5	17	16.7	1.00	—
Prescription coverageb
Yes	1,455	72.1	364	27.0	1.21	0.88–1.67
No	570	27.9	110	20.5	1.00	—
Received a medication management visitb
Yes	195	9.9	93	48.7	2.65c	1.79–3.93
No	1,830	90.1	381	22.7	1.00	—
Health
Very good/excellent	517	26.1	149	28.9	1.00	—
Good	598	31.0	135	24.8	0.97	0.67–1.38
Fair/poor	901	42.9	185	22.9	0.88	0.63–1.24
Number of comorbid conditions
0 and 1	350	18.7	96	28.8	1.00	—
2–4	1,344	65.8	304	25.0	0.98	0.66–1.46
≥5	330	15.5	73	21.9	0.96	0.53–1.74
Year of diagnosis
1992	194	9.51	48	26.1	1.00	—
1993	255	12.69	65	26.8	0.94	0.61–1.46
1994	231	10.93	53	24.7	0.91	0.58–1.40
1995	205	10.41	51	27.2	0.97	0.57–1.66
1996	278	14.43	65	25.4	0.98	0.59–1.63
1997	292	14.96	59	23.2	0.73	0.46–1.16
1998	343	16.48	82	25.9	1.03	0.63–1.69
1999	227	10.60	51	22.8	0.83	0.50–1.39
Availability of psychotherapy providers in the   beneficiary’s county of residence   Psychiatristb
Yes	1,615	81.4	428	28.5	2.19c	1.44–3.33
No	410	18.6	46	11.1	1.00	—
Mental health centerb
Yes	1,010	51.1	296	31.1	1.50c	1.03–2.21
No	1,015	48.9	178	19.1	1.00	—

^aData were based on episodes of depression constructed from the claims of a nationally representative sample of elderly Medicare beneficiaries with a diagnosis of depression between calendar years 1992 and 1999 who were age 65 years and older, enrolled in fee-for-service Medicare throughout the episode, and living in the community. Percentages are weighted for the complex design of the Medicare Current Beneficiary Survey.

^bSignificant difference in rate of psychotherapy treatment (p<0.05, chi-square test).

^cSignificant effect (p<0.05) on psychotherapy treatment in the multiple logistic regression.

^dSignificant effect (p<0.10) on psychotherapy treatment in the multiple logistic regression.

^eNot included in multiple logistic regression analysis because of colinearity with availability of a psychiatrist and mental health center in the county of residence.

^fSignificant difference in rate of psychotherapy treatment (p<0.10, chi-square test).