Depression and anxiety correlate differentially with dissatisfaction with healthcare services in older adults: The Yilan Study, Taiwan

Background/Purpose Previous studies have seldom investigated the psychological factors that are associated with dissatisfaction with healthcare services. We therefore examined the associations of depression and anxiety with service dissatisfaction among older adults. Methods A community-based health survey was conducted from 2012 to 2016. Residents aged ≥65 years were randomly recruited from Yilan City, Taiwan. Besides overall dissatisfaction, we assessed dissatisfaction with physicians' ability, physicians’ attitude, and waiting time. The Hospital Anxiety and Depression Scale was used to detect depressive and anxiety symptoms with optimal cut-off points of 3 for the anxiety subscale and 6 for the depression subscales. Results Of the 3480 residents included in this study, the overall dissatisfaction rate was 7.9%. After controlling for covariates, depressive and anxiety symptoms were consistently correlated with the various dimensions of dissatisfaction. More specifically, depressive symptoms were associated with overall dissatisfaction and dissatisfaction with physicians’ ability and attitude. Conversely, anxiety was uniquely associated with dissatisfaction with waiting time. Conclusion Psychological symptoms were consistent correlates of dissatisfaction with healthcare services among older adults, although the specific symptoms had different associations with the various dimensions of dissatisfaction.