Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland , Kuopio , Finland.
Primary Health Care Unit, Kuopio University Hospital , Kuopio , Finland.
Scand J Prim Health Care. 2019 Sep;37(3):312-318. doi: 10.1080/02813432.2019.1639904. Epub 2019 Jul 18.
To examine health service (HS) utilization profiles among a non-depressive population and patients with depressive symptoms (DS) with and without clinical depression. The study population was based on primary care patients with DS scoring ≥10 in the 21-item Beck Depression Inventory (BDI) and who were at least 35 years old and had been referred to depression nurse case managers ( = 705). Their psychiatric diagnosis was confirmed with the Mini-International Neuropsychiatric Interview (M.I.N.I.). Of these patients, 447 had clinical depression. The number of patients with DS without clinical depression was 258. The control group consisted of a random sample of 414 residents with a BDI score < 10. Use of HS (visits and phone calls to a doctor and a nurse) was based on patient records. Number of visits and calls to physicians and nurses. Patients with DS regardless of their depression diagnosis used primary health care (PHC) services three times more than the controls ( < 0.001). In the secondary care, the differences were smaller but significant. Of the controls, 70% had 0-4 HS contacts per year whereas a majority of the patients having DS had more than 5 contacts per year. The number of contacts correlated with the BDI from a score of 0 to 10 but not as clearly in the higher scores. Depressive symptoms, both with or without clinical depression, are associated with increased HS use, especially in PHC. This study suggests that even mild depressive symptoms are associated with an increased use of HS. KEY POINTS We analyzed the health service (HS) use among primary health care patients screened for depression and non-depressive population. Screen positive patients without clinical depression used as much HS as those having clinical depression. Regardless of depression diagnosis, screen positive patients visited a GP and nurse three times more often than the control population. In the screen negative control population, milder depressive symptoms were correlated with the use of HS. Primary health care was responsible for most of the HS use among patients having depressive symptoms.
为了研究非抑郁人群和伴有或不伴有临床抑郁的抑郁症状（DS）患者的健康服务（HS）利用情况。研究人群为在贝克抑郁量表（BDI）中得分≥10 的 DS 评分且年龄至少为 35 岁并已转诊给抑郁护士个案管理者的初级保健患者（ = 705）。他们的精神科诊断通过迷你国际神经精神访谈（MINI）确认。在这些患者中，447 人患有临床抑郁症。258 人患有无临床抑郁症的 DS。对照组由 BDI 评分<10 的随机 414 名居民组成。HS（就诊和致电医生和护士的次数）的使用基于患者记录。医生和护士的就诊和致电次数。无论抑郁诊断如何，DS 患者使用初级保健（PHC）服务的次数是对照组的三倍（ < 0.001）。在二级保健中，差异较小但有统计学意义。对照组中，70%的人每年有 0-4 次 HS 接触，而大多数患有 DS 的患者每年有超过 5 次接触。接触次数与 BDI 评分从 0 到 10 相关，但在较高评分中相关性不明显。伴有或不伴有临床抑郁的抑郁症状与 HS 使用增加相关，尤其是在 PHC。本研究表明，即使是轻度抑郁症状也与 HS 使用增加相关。要点 我们分析了筛选出的抑郁患者和非抑郁人群的初级保健患者的 HS 使用情况。无临床抑郁的筛查阳性患者与有临床抑郁的患者使用的 HS 量相同。无论是否有抑郁诊断，筛查阳性患者看全科医生和护士的次数比对照组多三倍。在筛查阴性对照组中，轻度抑郁症状与 HS 使用相关。初级保健在有抑郁症状的患者中使用的 HS 最多。
