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医疗保险补充保险人群中,抑郁症状和各种慢性疾病及健康问题对生活质量的负担。

The burden of depressive symptoms and various chronic conditions and health concerns on the quality of life among those with Medicare Supplement Insurance.

机构信息

UnitedHealth Group Alliances, Minnetonka, MN, USA.

出版信息

Int J Geriatr Psychiatry. 2012 Sep;27(9):948-58. doi: 10.1002/gps.2806. Epub 2011 Oct 25.

DOI:10.1002/gps.2806
PMID:22025352
Abstract

OBJECTIVE

This study aims to estimate the burden of currently having depressive symptoms on quality of life independently and in combination with various chronic conditions/health concerns among adults with Medicare Supplement Insurance (i.e., Medigap) coverage.

METHODS

Data were obtained from the Health Update Survey (HUS). The HUS contains questions on demographics, comorbid conditions, and all of the questions on the Veterans RAND 12-item (VR-12) health status/quality of life survey. The survey was mailed to a random sample of 30,000 insureds from 10 states between 2008 and 2009. On the basis of relevant questions from the survey, respondents were categorized into two groups: those currently suffering from current depressive symptoms (N = 2283) and those who never had depressive symptoms (N = 7058). Multiple regression modeling was used to test the impact on quality of life of depressive symptoms independently or as an interaction of depressive symptoms with various chronic conditions/health concerns.

RESULTS

Depressive symptoms were common, with an estimated prevalence of 24.4%. The greatest impact of depressive symptoms in combination with various chronic conditions/health concerns on quality of life was on the ability to handle emotional roles, bodily pain, social functioning, and ability to handle physical roles. Most of the significant interactions between depressive symptoms and various chronic conditions/health concerns were demonstrated for those chronic conditions contributing to functional impairment (e.g., difficulty walking, falls, chronic pain, and diabetes).

CONCLUSIONS

Although depressive symptoms independently reduced quality of life, having depressive symptoms in addition to other chronic conditions/health concerns had a greater impact on quality of life.

摘要

目的

本研究旨在评估在有医疗保险补充保险(即 Medigap)覆盖的成年人中,目前患有抑郁症状对生活质量的影响,以及这种影响与各种慢性疾病/健康问题单独或联合存在时的影响。

方法

数据来自健康更新调查(HUS)。HUS 包含了人口统计学、合并症以及退伍军人 RAND 12 项(VR-12)健康状况/生活质量调查的所有问题的信息。该调查于 2008 年至 2009 年期间邮寄给来自 10 个州的 30000 名参保人。根据调查中的相关问题,将受访者分为两组:目前患有当前抑郁症状的组(N=2283)和从未患有抑郁症状的组(N=7058)。使用多元回归模型来测试抑郁症状对生活质量的影响,这种影响是抑郁症状独立存在或与各种慢性疾病/健康问题共同存在时产生的。

结果

抑郁症状较为常见,估计患病率为 24.4%。抑郁症状与各种慢性疾病/健康问题共同存在对生活质量的影响最大的方面是对情绪角色、身体疼痛、社会功能和处理身体角色的能力的影响。在各种慢性疾病/健康问题中,导致功能障碍的慢性疾病(如行走困难、跌倒、慢性疼痛和糖尿病)与抑郁症状之间存在大多数显著的相互作用。

结论

尽管抑郁症状独立地降低了生活质量,但患有抑郁症状加上其他慢性疾病/健康问题对生活质量的影响更大。

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