Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany.
Gen Hosp Psychiatry. 2011 Sep-Oct;33(5):443-53. doi: 10.1016/j.genhosppsych.2011.06.013. Epub 2011 Aug 9.
The aim of this study was to systematically review the impact of comorbid mental disorders on health care costs in adult persons with asthma.
A comprehensive search for studies investigating adult persons (≥18 years) with asthma was conducted. All studies were included, which allowed a comparison of health care utilization and costs between asthma patients with mental disorders and asthma patients without.
The literature search revealed 1977 potentially relevant studies. Eighteen primary studies (20 publications) fulfilled the inclusion criteria. Mood disorders (n=14) and anxiety disorders (n=9) were studied most often. Increased rates of hospitalizations (odds ratio range, 0.9-6.1; n=7), emergency department visits (odds ratio range, 1.8-17.2; n=7) and general practitioner visits (standardized mean difference range, 0.1-1.1; n=6) were found in asthma patients with mental comorbidity. Indirect costs of work absence were investigated in two studies pointing in the same direction of increased costs. Evidence is sparse regarding other outcomes due to a lack of primary studies.
The present systematic review highlights a meaningful impact of comorbid mental disorders on health care utilization and costs in adult patients with asthma. Thus, psychodiagnostic routines and appropriate mental health treatments are needed to reduce health care costs in asthma care.
本研究旨在系统回顾合并精神障碍对成年哮喘患者医疗费用的影响。
对调查成年（≥18 岁）哮喘患者的研究进行了全面检索。所有允许比较哮喘伴精神障碍患者和无精神障碍患者医疗利用和费用的研究均被纳入。
文献检索显示有 1977 篇潜在相关研究。18 项初级研究（20 篇文献）符合纳入标准。心境障碍（n=14）和焦虑障碍（n=9）研究最多。合并精神障碍的哮喘患者住院率（比值比范围，0.9-6.1；n=7）、急诊就诊率（比值比范围，1.8-17.2；n=7）和全科医生就诊率（标准化均数差值范围，0.1-1.1；n=6）均增加。两项研究调查了缺勤的间接成本，结果均表明成本增加。由于缺乏初级研究，其他结果的证据稀疏。
本系统综述强调了合并精神障碍对成年哮喘患者医疗利用和费用的显著影响。因此，需要进行精神诊断常规检查和适当的精神卫生治疗，以降低哮喘护理的医疗费用。
