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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 2/2019

01-02-2019 | Original Paper

Associations between untreated depression and secondary health care utilization in patients with hypertension and/or diabetes

Authors: Anita Pálinkás, János Sándor, Magor Papp, László Kőrösi, Zsófia Falusi, László Pál, Zsuzsanna Bélteczki, Zoltán Rihmer, Péter Döme

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 2/2019

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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.
Appendix
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Metadata
Title
Associations between untreated depression and secondary health care utilization in patients with hypertension and/or diabetes
Authors
Anita Pálinkás
János Sándor
Magor Papp
László Kőrösi
Zsófia Falusi
László Pál
Zsuzsanna Bélteczki
Zoltán Rihmer
Péter Döme
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 2/2019
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-018-1545-7

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