Mental health status and use of general medical services for persons with human immunodeficiency virus
Mental health status and use of general medical services for persons with human immunodeficiency virus
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DOI：
10.1097/01.mlr.0000170423.61316.05
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发表时间：
2005-08-01
期刊：
影响因子：
3
通讯作者：
Burnam, MA
中科院分区：
文献类型：
--
作者：
Joyce, GF;Chan, KS;Burnam, MA
背景：严重疾病往往伴随着心理困扰。有精神障碍或症状的人的发病率和死亡率更高，社会功能更差，使用普通医疗服务的比例更高。目标：我们试图检查心理健康与使用普通医疗服务的关系。设计和参与者：我们使用了来自HIV成本和服务利用研究(HCSUS)的纵向数据，这是一个具有全国代表性的样本，包括2267名接受护理的HIV+成年人，他们在18个月的时间里完成了所有3次访谈。主要观察指标：使用概率和一般医疗费用，结果：在调整疾病严重程度和患者特征后，在接下来的12个月中，筛查出抑郁阳性或有5个或5个以上精神健康症状的艾滋病毒感染者在一般医疗服务上的花费比没有心理健康症状的艾滋病毒感染者多20%至25%。结论：心理困扰仍然是一般医疗服务使用的一个独立预测因素，尽管随着对身体健康状况和既往服务使用的更好控制，其影响的程度会减弱。识别出有情感或焦虑症症状的艾滋病毒患者可能会适度降低总体治疗成本。
Background: Serious medical illness often is accompanied by psychological distress. Individuals experiencing mental disorders or symptoms have higher rates of morbidity and mortality, worse social functioning, and use of general medical services.Objectives: We sought to examine the association between mental health and use of general medical services for persons in care for HIV.Design and Participants: We used longitudinal data from the HIV Cost and Services Utilization Study (HCSUS), a nationally representative sample of 2267 HIV+ adults receiving care and who completed all 3 interviews during an 18-month period.Main Outcome Measures: Probability of use and general medical expenditures, by type of service.Results: HIV+ individuals who screened positive for depression or had 5 or more mental health symptoms at baseline spent 20% to 25% more for general medical services in the following 12 months than HIV+ adults without mental health symptoms, after adjusting for disease severity and patient characteristics. Higher spending was largely the result of greater use of inpatient and emergency services.Conclusions: Psychological distress remains an independent predictor of general medical service use, although the magnitude of effect diminishes with better controls for physical well-being and previous service use. Identifying HIV patients with symptoms of affective or anxiety disorders may reduce overall treatment costs modestly.