Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland.
Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universitat zu Kiel, Kiel, Germany.
PLoS One. 2018 Jun 14;13(6):e0198890. doi: 10.1371/journal.pone.0198890. eCollection 2018.
Depression is a global health problem associated with a significant public health burden and costs. Although studies on costs of diseases are being considered as an increasingly important factor for health policies, information concerning costs of inpatient care of depression is still insufficient. Thus, the main aim of this study was to evaluate costs of hospitalization of patients treated in 2016 in psychiatric clinics in Poznan (Poland) and in Kiel (Germany) and to analyze treatment used in these centers. The study was conducted from September 2017 to February 2018. 545 hospital records were considered (187 in Poznan and 358 in Kiel). Eventually, 490 hospital records were included, 168 in Poland and 322 in Germany. In general, the costs were calculated based on the patients' sex and diagnosis (F32 and F33) separately and, subsequently, the outcomes were added and multiplied by the length of hospital stay, giving the cost of hospitalization. The annual cost of inpatient care of depression in 2016 was EUR 491,067.19 ([Formula: see text]) in Poznan and EUR 2,847,991.00 [Formula: see text] in Kiel. In Poznan, hospitalization was underfunded reaching EUR 183,042.55 (37.27% of total costs in Poznan). In Poznan, the most frequently prescribed medicine was quetiapine, followed by olanzapine and venlafaxine, whereas in Kiel it was venlafaxine, followed by mirtazapine and promethazine. Although non-pharmacological therapies were commonly used in both centers, in Kiel this type of treatment was better structured. The study confirms the degree of the economic burden of inpatient care of depression. The underfunding of mental health revealed, emphasizes the need for urgent amendment of organization and funding of mental health care in Poland. Patients in Poznan were hospitalized on average 10 days longer than in Kiel, thus a reduction of length of hospitalization in Poznan seems possible. Although pharmacotherapy seemed to be comprehensive in both centers, there were some differences between Poznan and Kiel. Access to non-pharmacological therapies during outpatient care was limited in Poznan, however, compared to Kiel.
抑郁症是一个全球性的健康问题，给公共卫生带来了巨大的负担和成本。尽管对疾病成本的研究被认为是卫生政策的一个越来越重要的因素，但关于抑郁症住院治疗成本的信息仍然不足。因此，本研究的主要目的是评估 2016 年在波兹南（波兰）和基尔（德国）的精神病诊所接受治疗的患者的住院费用，并分析这些中心使用的治疗方法。该研究于 2017 年 9 月至 2018 年 2 月进行。共考虑了 545 份住院病历（波兹南 187 份，基尔 358 份）。最终，纳入了 490 份住院病历，其中波兰 168 份，德国 322 份。总体而言，费用是根据患者的性别和诊断（F32 和 F33）分别计算的，然后将结果相加并乘以住院时间，得出住院费用。2016 年抑郁症患者的住院费用为 491,067.19 欧元（[公式：见正文]）在波兹南和 2,847,991.00 欧元[公式：见正文]在基尔。在波兹南，住院治疗资金不足，达到 183,042.55 欧元（波兹南总费用的 37.27%）。在波兹南，最常开的药物是喹硫平，其次是奥氮平和文拉法辛，而在基尔，最常开的是文拉法辛，其次是米氮平和异丙嗪。尽管两个中心都经常使用非药物治疗，但在基尔，这种治疗方法结构更好。该研究证实了抑郁症住院治疗的经济负担程度。精神卫生资金不足，强调了波兰迫切需要修订精神卫生保健的组织和资金。波兹南的患者平均住院时间比基尔多 10 天，因此波兹南的住院时间似乎可以缩短。尽管两个中心的药物治疗似乎都很全面，但波兹南和基尔之间仍存在一些差异。波兹南的门诊治疗中获得非药物治疗的机会有限，与基尔相比。
