Anita Pálinkás1, János Sándor2, Magor Papp3, László Kőrösi4, Zsófia Falusi4, László Pál4, Zsuzsanna Bélteczki5, Zoltán Rihmer6,7, Péter Döme6,7. 1. Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, POB. 400, 4002, Hungary. 2. Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, POB. 400, 4002, Hungary. sandor.janos@sph.unideb.hu. 3. National Institute of Health Promotion, Budapest, Hungary. 4. Department of Financing, National Institute of Health Insurance Fund Management, Budapest, Hungary. 5. Santha Kalman Mental Health Centre and Special Hospital, Nagykallo, Hungary. 6. Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary. 7. Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest, Hungary.
Abstract
PURPOSE: We determined the prevalence of untreated depression in patients with hypertension (HT) and/or diabetes (DM) and estimated the extra health care use and expenditures associated with this comorbidity in a rural Hungarian adult population. We also assessed the potential workload of systematic screening for depression in this patient group. METHODS: General health check database from a primary care programme containing survey data of 2027 patients with HT and/or DM was linked to the outpatient secondary care use database of National Institute of Health Insurance Fund Management. Depression was ascertained by Beck Depression Inventory score and antidepressant drug use. The association between untreated depression and secondary healthcare utilization indicated by number of visits and expenses was evaluated by multiple logistic regression analysis controlled for socioeconomic/lifestyle factors and comorbidity. The age-, sex- and education-specific observations were used to estimate the screening workload for an average general medical practice. RESULTS: The frequency of untreated depression was 27.08%. The untreated severe depression (7.45%) was associated with increased number of visits (OR 1.60, 95% CI 1.11-2.31) and related expenses (OR 2.20, 95% CI 1.50-3.22) in a socioeconomic status-independent manner. To identify untreated depression cases among patients with HT and/or DM, an average GP has to screen 42 subjects a month. CONCLUSION: It seems to be reasonable and feasible to screen for depression in patients with HT and/or DM in the primary care, in order to detect cases without treatment (which may be associated with increase of secondary care visits and expenditures) and to initiate the adequate treatment of them.
PURPOSE: We determined the prevalence of untreated depression in patients with hypertension (HT) and/or diabetes (DM) and estimated the extra health care use and expenditures associated with this comorbidity in a rural Hungarian adult population. We also assessed the potential workload of systematic screening for depression in this patient group. METHODS: General health check database from a primary care programme containing survey data of 2027 patients with HT and/or DM was linked to the outpatient secondary care use database of National Institute of Health Insurance Fund Management. Depression was ascertained by Beck Depression Inventory score and antidepressant drug use. The association between untreated depression and secondary healthcare utilization indicated by number of visits and expenses was evaluated by multiple logistic regression analysis controlled for socioeconomic/lifestyle factors and comorbidity. The age-, sex- and education-specific observations were used to estimate the screening workload for an average general medical practice. RESULTS: The frequency of untreated depression was 27.08%. The untreated severe depression (7.45%) was associated with increased number of visits (OR 1.60, 95% CI 1.11-2.31) and related expenses (OR 2.20, 95% CI 1.50-3.22) in a socioeconomic status-independent manner. To identify untreated depression cases among patients with HT and/or DM, an average GP has to screen 42 subjects a month. CONCLUSION: It seems to be reasonable and feasible to screen for depression in patients with HT and/or DM in the primary care, in order to detect cases without treatment (which may be associated with increase of secondary care visits and expenditures) and to initiate the adequate treatment of them.
Entities:
Keywords:
Comorbid depression; Diabetes; Health care utilization; Hypertension; Linkage study
Authors: Yun Wu; Sihui Jin; Jianwei Guo; Yi Zhu; Lijin Chen; Yixiang Huang Journal: Int J Environ Res Public Health Date: 2022-10-10 Impact factor: 4.614