NDLI: Perceived need for treatment and non-utilization of outpatient psychotherapy in old age: two cohorts of a nationwide survey

Content Provider	Springer Nature : BioMed Central
Author	Gellert, Paul Lech, Sonia Kessler, Eva-Marie Herrmann, Wolfram Döpfmer, Susanne Balke, Klaus Oedekoven, Monika Kuhlmey, Adelheid Schnitzer, Susanne
Abstract	Beackground Older adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation to rates of non-utilization of outpatient psychotherapy as well as the predisposing, enabling, and need factors proposed by Andersen’s Model of Health Care Utilization that account for these differences warrant further investigation. Methods We used two separate cohorts (2014 and 2019) of a weighted nationwide telephone survey in Germany of German-speaking adults with N = 12,197 participants. Across the two cohorts, 12.9% (weighted) reported a perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency, general health status), enabling (education, general practitioner visit) non-utilization of psychotherapy (outcome) across cohorts in those with a need for treatment (need factor). Results In 2014, 11.8% of 6087 participants reported a perceived need for treatment due to mental health problems. In 2016, the prevalence increased significantly to 14.0% of 6110 participants. Of those who reported a perceived need for treatment, 36.4% in 2014 and 36.9%in 2019 did not see a psychotherapist – where rates of non-utilization of psychotherapy were vastly higher in the oldest age category (59.3/52.5%; 75+) than in the youngest (29.1/10.7%; aged 18–25). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (55–64 OR 1.02, 65–74 OR 1.47, 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model. Conclusion There is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet treatment needs are required.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-021-06384-6.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-021-06384-6
Journal	BMC Health Services Research
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2021-05-10
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Psychotherapy Healthcare utilization Andersen’s model of health service use Unmet need for treatment Perceived need for treatment Old age
Content Type	Text
Resource Type	Article
Subject	Health Policy

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