National Trends in the Treatment for Depression From 1998 to 2007
National Trends in the Treatment for Depression From 1998 to 2007
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DOI：
10.1001/archgenpsychiatry.2010.151
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发表时间：
2010-12-01
影响因子：
--
通讯作者：
Olfson, Mark
中科院分区：
文献类型：
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作者：
Marcus, Steven C.;Olfson, Mark
背景：1987至1997年间，美国抑郁症的门诊治疗率显著增加；目的：评估1998至2007年间全国抑郁症门诊治疗的趋势。设计和背景：分析1998年(n=22 953)和2007年(n=29 370)两次具有全国代表性的美国家庭人口调查的服务利用数据。参与者：美国家庭人口的全国代表性样本。主要观察指标：抑郁症治疗率和接受治疗的患者中，抗抑郁药物的使用率，心理治疗，门诊治疗次数，结果：抑郁症的门诊治疗率从1998年的2.37/100人上升到2007年的2.88/100人(调整后的优势比为1.18；95%可信区间[CI]，1.03-1.35)。接受治疗的患者使用抗抑郁药物的比例从1998年的73.8%下降到2007年的75.3%(AOR，1.14；95%CI，0.85-1.51)，但接受心理治疗的患者比例从1998年的53.6%下降到2007年的43.1%(AOR，0.71；95%CI，0.53-0.95)。国家用于抑郁症门诊治疗的支出从100.5亿美元增加到124.5亿美元(z=1.73，P=0.08)。这主要是由于药物支出从1998年的45.9亿美元增加到2007年的66亿美元(z=2.88，P=0.004)，这又与用于抑郁症治疗的医疗保险支出从1998年的5.2亿美元增加到2007年的22.5亿美元有关(z=5.62，P
Context: The rate of outpatient treatment of depression increased markedly in the United States between 1987 and 1997; it is not known whether this trend has continued.Objective: To assess national trends in the outpatient treatment of depression between 1998 and 2007.Design and Setting: Analysis of service utilization data from 2 nationally representative surveys of the US household population, the 1998 (n=22 953) and 2007 (n=29 370) Medical Expenditure Panel Surveys.Participants: Nationally representative sample of the US household population.Main Outcome Measures: The rate of depression treatment and, among patients who received treatment, the rate of antidepressant medication use, psychotherapy, number of outpatient treatment visits, and expenditures.Results: The rate of outpatient treatment for depression increased from 2.37 per 100 persons in 1998 to 2.88 per 100 persons in 2007 (adjusted odds ratio [AOR], 1.18; 95% confidence interval [CI], 1.03-1.35). The percentage of treated patients who used antidepressants was little changed from 73.8% (1998) to 75.3% (2007) (AOR, 1.14; 95% CI, 0.85-1.51), but the percentage of those receiving psychotherapy declined from 53.6% (1998) to 43.1% (2007) (AOR, 0.71; 95% CI, 0.53-0.95). National expenditures for the outpatient treatment of depression increased from $10.05 billion to $12.45 billion (z=1.73, P=.08). This was primarily driven by an increase in medication expenditures from $4.59 billion (1998) to $6.60 billion (2007) (z=2.88, P=.004), which in turn was related to an increase in Medicare expenditures for depression treatment from $0.52 billion (1998) to $2.25 billion (2007) (z=5.62, P