Diagnosis, treatment, comorbidity, and resource utilization of depressed patients in a general medical practice
Diagnosis, treatment, comorbidity, and resource utilization of depressed patients in a general medical practice
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DOI：
10.2190/ytry-e86m-g1vc-lc79
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发表时间：
2000-01-01
影响因子：
2
通讯作者：
Charlson, ME
中科院分区：
文献类型：
--
作者：
Luber, MP;Hollenberg, JP;Charlson, ME
目的：本研究的目的是确定抑郁症对卫生保健资源利用的影响，调整后的年龄和合并症从常规临床实践中获得的数据。方法：该研究是一项观察性队列研究，包括15，186例患者，从1993年12月开始随访一年。综合人口统计学，临床和利用数据可从计算机化的医疗信息系统生成的数据库中的一般内科实践在城市学术医疗中心。结果：4.7%的患者进行了抑郁症的提供者编码诊断。关于卫生保健资源的利用，即使在控制了年龄和合并症后，抑郁症患者有更多的初级保健就诊（5.3 vs. 2.9，p <0.001），更高的专家转诊率（1.1 vs. 0.5，p <0.002）和放射学检查率（0.9 vs. 0.4，p <0.001）。他们的门诊总费用（1,324美元对701美元，p <0.001）和总费用（2,808美元对1,891美元，p <0.001）更高。抑郁症患者住院时间也较长（14.1 vs. 9.5天，p <0.002）。结论：被诊断为抑郁症的患者对所有类型的资源利用率都显着较高，即使在控制了与抑郁症相关的共病医疗疾病的较高负担之后。
Objective: The objective of the study was to determine the effect of depression on the utilization of health care resources, after adjusting for age and comorbidity from data obtained on routine clinical practice. Method: The study is an observational cohort of 15,186 patients followed over a one-year period beginning December 1993. Comprehensive demographic, clinical, and utilization data were available from the computerized medical information system generated database of a general internal medicine practice in an urban academic medical center. Results: Four point seven percent of patients carried a provider-coded diagnosis of depression. With regards to utilization of health care resources, even after controlling for age and comorbidity, depressed patients had more primary care visits (5.3 vs. 2.9 visits, p < .001), higher rates of referral to specialists (1.1 vs. 0.5,p < .002), and radiologic tests (0.9 vs. 0.4 tests, p < .001). They had higher total outpatient charges ($1,324 vs. $701,p < .001) and total charges ($2,808 vs. $1,891,p < .001). Depressed patients also had longer length of stay when hospitalized (14.1 vs. 9.5 days, p < .002). Conclusions: Patients diagnosed as depressed had significantly higher resource utilization of all types, even after controlling for the higher burden of comorbid medical illness associated with depression.