Health care costs associated with depressive and anxiety disorders in primary care.
Health care costs associated with depressive and anxiety disorders in primary care.
复制标题
初级保健中与抑郁症和焦虑症相关的医疗保健费用。
DOI：
10.1176/ajp.152.3.352
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Barlow,W
中科院分区：
文献类型：
--
作者：
Simon,G;Ormel,J;VonKorff,M;Barlow,W
目的：作者研究了与初级保健患者中抑郁和焦虑相关的整体医疗费用。方法：在健康维护组织中的10名连续初级保健患者中，用12项一般健康问卷对1，962名患者进行筛查。分层随机抽取615例患者进行进一步的诊断评估，其中373例患者在基线时完成了复合国际诊断访谈，328例在12个月后重新评估。使用计算机化的成本记录来计算基线评估前后6个月的总医疗保健成本，以及随访评估前后类似的时间段。基线时327例患者和两次评估时206例患者的成本核算数据可用。结果如下：初级保健患者与DSM-III-R焦虑或抑郁障碍在基线有显着较高的基线成本（2,390美元）比患者阈下障碍（1,098美元）和那些没有焦虑或抑郁障碍（1美元，397）。在对医疗发病率进行调整后，仍然存在较大的成本差异。费用差异反映了一般医疗服务的利用率较高，而不是心理健康治疗费用较高。虽然大多数基线焦虑或抑郁障碍患者表现出显着的改善，纵向分析没有显示任何明确的关系，精神病诊断的变化和医疗费用的变化。结论：在初级保健患者中，焦虑和抑郁障碍与显著更高的医疗保健费用相关，即使在调整医疗合并症后。在这个小样本中，1年以上抑郁症的改善与成本的降低没有明显相关性。
Objective: The authors examined the overall health care costs associated with depression and anxiety among primary care patients. Method: I 1 0 consecutive primary care patients in a health maintenance organization, 1,962 were screened with the 12-item General Health Q uestionnaire. A stratified random sample of6l 5 patients were selected for further diagnostic assessment; 3 73 ofthese patients completed the Composite International Diagnostic Interview at baseline and 328 were reassessed 12 months later. Computerized cost records were used to calculate total health care costs for the 6-month period surrounding the baseline assessment and a similar period surrounding the follow-up assessment. Cost accounting data were available for 327 patients at baseline and for 206 patients at both assessments. Results: Primary care patients with DSM-III-R anxiety or depressive disorders at baseline had markedly higher baseline costs ($2,390) than patients with subthreshold disorders($1,098) and those with no anxiety or depressive disorder($ I, 3 97). Large cost differences persisted after adjustment for medical morbidity. Cost differences reflected higher utilization of general medical services rather than higher mental health treatment costs. Although most patients with baseline anxiety or depressive disorders showed significant improvement, longitudinal analyses did not show any clear relationship between change in psychiatric diagnosis and change in health care cost. Conclusions: Among primary care patients, anxiety and depressive disorders are associated with markedly higher health care costs even after adjustment for medical comorbidity. In this small sample, improvement in depression over 1 year was not clearly associated with decreases in cost.