巴斯克地区2型糖尿病成年患者的抑郁症患病率:与血糖控制及医疗保健成本的关系
Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs.
作者信息
Alonso-Morán Edurne, Satylganova Altynai, Orueta Juan F, Nuño-Solinis Roberto
机构信息
O+berri, Basque Institute for Healthcare Innovation, Torre del BEC (Bilbao Exhibition Centre), Ronda de Azkue 1, 48902 Barakaldo, Spain.
出版信息
BMC Public Health. 2014 Jul 30;14:769. doi: 10.1186/1471-2458-14-769.
BACKGROUND
The aim of the study was to estimate the prevalence of depression in the population diagnosed with diabetes type 2 and to test the hypothesis that the presence of depression in such cases was associated with a) worse glycaemic control, and b) higher healthcare costs.
METHODS
We conducted a cross-sectional analysis, from 1st September 2010 to 31st August 2011, among patients with type 2 diabetes aged 35 years and over in the Basque Country. It was identified how many of them had also depression. The database included administrative individual level information on age, sex, healthcare costs, other comorbidities, and values of glycaemic control (HbA1c). Deprivation index variable was used as socioeconomic measure and, to observe the coexistent pathologies, all the patients diagnoses were categorized by Adjusted Clinical Groups. We used a measure of association, a logistic and a linear regression for analysis.
RESULTS
12.392 (9.8%) of type 2 diabetes patients were diagnosed with depression, being the prevalence 5.2% for males and 15.1% for females. This comorbidity was higher among the most deprived population. There was no association between the presence of depression and glycaemic control. We estimated that the comorbidity average cost per patient/year was 516€ higher than in patients with just type 2 diabetes (P < 0.001) adjusted by the other covariates.
CONCLUSIONS
We did not find any relationship between depression and glycaemic control in patients with type 2 diabetes. However, the comorbidity was associated with significantly high healthcare costs compared to that of type 2 diabetes occurring alone, after adjusting by other illness. Thus, there is a need of more precise recognition, screening and monitoring of depression among diabetic population. Evidence-based treatment for depression should be included in type 2 diabetes clinical guidelines.
背景
本研究的目的是评估2型糖尿病患者中抑郁症的患病率,并检验以下假设:此类患者中抑郁症的存在与a)血糖控制较差以及b)更高的医疗费用相关。
方法
2010年9月1日至2011年8月31日,我们在巴斯克地区对35岁及以上的2型糖尿病患者进行了横断面分析。确定其中有多少人同时患有抑郁症。数据库包含了关于年龄、性别、医疗费用、其他合并症以及血糖控制值(糖化血红蛋白)的个人行政层面信息。剥夺指数变量用作社会经济指标,为观察并存的病症,所有患者的诊断按调整后的临床分组进行分类。我们使用关联度量、逻辑回归和线性回归进行分析。
结果
12392名(9.8%)2型糖尿病患者被诊断出患有抑郁症,男性患病率为5.2%,女性为15.1%。这种合并症在最贫困人群中更高。抑郁症的存在与血糖控制之间没有关联。我们估计,经其他协变量调整后,合并症患者每年的平均费用比仅患有2型糖尿病的患者高516欧元(P < 0.001)。
结论
我们未发现2型糖尿病患者的抑郁症与血糖控制之间存在任何关系。然而,与单独发生的2型糖尿病相比,在调整其他疾病后,这种合并症与显著更高的医疗费用相关。因此,需要在糖尿病患者中更精确地识别、筛查和监测抑郁症。2型糖尿病临床指南应纳入基于证据的抑郁症治疗方法。
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