Ohsfeldt Robert L, Lage Maureen J, Rajagopalan Krithika
Texas A&M Health Science Center, College Station.
Prim Care Companion J Clin Psychiatry. 2007;9(4):280-6. doi: 10.4088/pcc.v09n0405.
To identify resource use patterns and costs incurred during new episodes of bipolar disorder.
Researchers examined Medstat MarketScan databases covering the interval of January 1, 1998, to December 31, 2002, to identify 6148 patients with new episodes of bipolar disorder as defined by the International Classification of Diseases, Ninth Revision. Resource utilization patterns and costs for the 6 months prior to the index date and for the 30 days and 1 year after the index date were examined. Differences among subcategories of bipolar patients in terms of the resources used before and after the index date were also examined.
The majority of the individuals in the study were female (61.3%) and the mean age was 41.9 years. Patients diagnosed as manic had higher bipolar treatment costs (p < .01) and were more likely to be hospitalized for mental health diagnoses 30 days (p < .01) and 1 year after the index diagnosis (p = .02) compared with individuals diagnosed as depressive, mixed, or other/ unknown. Median total medical costs in the 1 year after the index date were highest for those diagnosed as depressed (p = .02), while patients diagnosed as mixed bipolar had significantly more psychiatrist visits after the index date (p < .01). Approximately 15% of patients were not treated with any central nervous system medication, and over 50% of patients were treated with antidepressants.
The subcategory of bipolar disorder that an individual is diagnosed as having significantly affects resource use and costs after such diagnosis. Patients diagnosed as manic generally used more resources than other individuals. In addition, results suggest that a large proportion of individuals are not being treated in accordance with recommended treatment guidelines.
确定双相情感障碍新发病例期间的资源使用模式和费用。
研究人员检查了涵盖1998年1月1日至2002年12月31日期间的Medstat MarketScan数据库，以识别6148例根据《国际疾病分类》第九版定义的双相情感障碍新发病例。研究了索引日期前6个月以及索引日期后30天和1年的资源利用模式和费用。还检查了双相情感障碍患者亚类别在索引日期前后使用资源方面的差异。
研究中的大多数个体为女性（61.3%），平均年龄为41.9岁。与被诊断为抑郁、混合或其他/不明类型的个体相比，被诊断为躁狂的患者双相情感障碍治疗费用更高（p <.01），并且在索引诊断后30天（p <.01）和1年（p =.02）因心理健康诊断住院的可能性更大。索引日期后1年，被诊断为抑郁的患者的医疗总费用中位数最高（p =.02），而被诊断为混合性双相情感障碍的患者在索引日期后看精神科医生的次数明显更多（p <.01）。约15%的患者未接受任何中枢神经系统药物治疗，超过50%的患者接受了抗抑郁药治疗。
个体被诊断患有的双相情感障碍亚类别在诊断后对资源使用和费用有显著影响。被诊断为躁狂的患者通常比其他个体使用更多资源。此外，结果表明很大一部分个体未按照推荐的治疗指南接受治疗。
