Welch Charles A, Czerwinski David, Ghimire Bijay, Bertsimas Dimitris
Somatic Therapies Consultation Service, Warren 601, Massachusetts General Hospital, Boston, MA 02114, USA.
Psychosomatics. 2009 Jul-Aug;50(4):392-401. doi: 10.1176/appi.psy.50.4.392.
In spite of its global importance, the interaction between depression and chronic comorbid diseases remains incompletely understood with regard to prevalence, severity of disease, and potential causative factors mediating this interaction.
The authors sought to compare overall medical costs in nondepressed and depressed individuals.
Insurance claims for 618,780 patients were examined for total annual non-mental health cost of care in 11 chronic diseases. In each disease cohort, median annual non-mental health cost was calculated for individuals with and without depression.
Patients with depression had higher median per-patient annual non-mental health costs than patients without depression in all 11 diseases studied. There was a higher-than-random comorbidity between depression and all 11 chronic comorbid diseases.
Even when controlling for number of chronic comorbid diseases, depressed patients had significantly higher costs than non-depressed patients, in a magnitude consistent across 11 chronic comorbid diseases.
尽管抑郁症与慢性共病在全球范围内具有重要意义,但关于它们之间的相互作用,在患病率、疾病严重程度以及介导这种相互作用的潜在致病因素方面,仍未完全了解。
作者试图比较非抑郁症患者和抑郁症患者的总体医疗费用。
对618,780名患者的保险理赔记录进行检查,以获取11种慢性病的年度非心理健康护理总费用。在每个疾病队列中,计算有抑郁症和无抑郁症患者的年度非心理健康费用中位数。
在所有11种研究疾病中,抑郁症患者的人均年度非心理健康费用中位数高于无抑郁症患者。抑郁症与所有11种慢性共病之间的共病率高于随机水平。
即使控制慢性共病的数量,抑郁症患者的费用仍显著高于非抑郁症患者,且在11种慢性共病中这种差异程度一致。