A community study of depression treatment and employment earnings.
A community study of depression treatment and employment earnings.
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抑郁症治疗和就业收入的社区研究。
DOI：
10.1176/ps.50.9.1209
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Smith,GR
中科院分区：
文献类型：
--
作者：
Zhang,M;Rost,KM;Fortney,JC;Smith,GR
虽然治疗重度抑郁症已被证明可以减少因失去工作日而导致的收入损失的成本，但研究尚未证明这种减少是否完全抵消了治疗该疾病的成本。方法：在基线和6个月和12个月的随访中，招募了全州范围内最近患有重度抑郁症、心境恶劣或严重抑郁症状的社区居民。收入损失的成本是通过损失的工作日乘以受试者的工资率来衡量的。抑郁症的治疗费用是使用从提供者和保险记录中提取的费用来估算的。净经济成本，定义为收入损失和抑郁症治疗成本变化的总和，在多元回归分析中进行了检查。没有发现抑郁症治疗对净经济成本的统计学显着影响。这一发现表明，抑郁症治疗的成本完全被减少抑郁症治疗的成本所抵消。失去的工作日在多个替代方案的敏感性分析结果支持相同的conclusionsThe发现的抑郁症治疗费用的完全抵消是保守的，因为其他好处，如减少疼痛和痛苦，提高生产力，而在工作中，不包括在分析。承担损失工作日费用的雇主应该鼓励患有抑郁症的员工寻求治疗，即使这意味着支付全部治疗费用。患有抑郁症的个体经营者也将受益，即使他们自己支付治疗费用。
OBJECTIVEAlthough treatment for major depression has been shown to reduce the costs of lost earnings resulting from lost work days, research has not demonstrated whether the reduction fully offsets the costs of treatment for the disorder.METHODSA statewide cohort of community residents with recent major depression, dysthymia, or substantial depressive symptoms was recruited and interviewed at baseline and at six-month and 12-month follow-ups. The cost of lost earnings was measured by lost work days multiplied by subjects' wage rates. Cost of treatment for depression was approximated using charges abstracted from provider and insurance records. Net economic cost, defined as the sum of changes in lost earnings and depression treatment costs, was examined in multiple regression analyses.RESULTSAfter the analyses controlled for sociodemographic characteristics, baseline severity of depression, and comorbidity, no statistically significant effect of depression treatment on net economic cost was found. This finding suggests that the cost of depression treatment was fully offset by savings from reduction in lost work days. Results from sensitivity analyses in multiple alternative scenarios support the same conclusion.CONCLUSIONSThe finding of a full offset of depression treatment cost is conservative because other benefits, such as reduced pain and suffering and increased productivity while at work, were not included in the analyses. Employers who bear the cost from lost work days should encourage their employees with depressive disorders to seek treatment, even if it means paying for the entire treatment cost. Self-employed individuals with depression also will benefit even if they pay for the treatment costs themselves.