Organizational profiles and personal factors affecting Health-related quality of life among older persons diagnosed with depressive disorders: path analysis and GEE

Abstract

Background Knowledge about mental health service use for depression, mediating organizational profiles, and personal factors on health-related quality of life (HRQoL) among older persons is critical to the health service system. Our study aimed to explore HRQoL six months through one year after persons received services for depression, and explains the effect of organizational profiles and personal factors on HRQoL, mediated through continued mental health service use. It also explains organizational profiles and personal factors affecting HRQoL. Method This study is a cross-sectional analytic study with information on 424 older persons (≥ 60 years) diagnosed with depressive disorder (DD)—medical record information provided data on personal and clinical factors. HRQoL and attitude toward depression and its treatment (ATDS) were obtained six months to one year after diagnosis with DD. HRQoL was measured using the EuroQol Group's EQ-5D Index and a visual analog scale (EQ-VAS). Organizational profiles were obtained from the authorized staff of 12 hospitals identified by latent class analysis into two classes. Descriptive statistics and path analysis tested mediated factors, and a marginal linear regression model using a generalized estimating equation (GEE) analyzed the final model. Results HRQoL at six months to one year was assessed as good and higher than in previous studies. Continuing mental health service use was not a mediated variable among organizational profiles and personal factors. HRQoL of older persons with DD is associated with personal factors, including age, sex, comorbidity, ATDS, perceived social support, and sufficient income. However, high and low-resource organizational profiles did not affect HRQoL. Conclusions These findings are crucial for reconsidering the quality of care and mental health services in general hospitals.