Division of Pharmacy Practice & Administrative Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, OH, USA.
Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
J Psychosoc Oncol. 2021;39(2):204-218. doi: 10.1080/07347332.2020.1844842. Epub 2020 Dec 7.
To compare the averages of healthcare services utilization and of expenditures for men with prostate cancer with and without diagnoses of mood disorders applying propensity score matching (PSM), and to identify the potential predictors associated with increased healthcare expenditures.
Cross-sectional study.
A total of 308,602 weighted patients with prostate cancer were identified after applying PSM. The datasets for men with prostate cancer were extracted from the Medical Expenditure Panel Survey (MEPS) from 2010 to 2015. For cohort formation, 1:1 PSM was applied. Healthcare utilization and expenditures analyzed included emergency room visits, length of stay for hospital inpatients, outpatient visits, office-based visits, and prescriptions. Generalized linear model with gamma distribution and log link was used to determine which covariates are associated with the increase in healthcare expenditures for each healthcare service.
The mean expenditures for emergency room visits between men with prostate cancer and mood disorders was $3,092.34, and it was $1,330.64 for patients without mood disorders ( = 0.038). The weighted total expenditures for emergency room visits in prostate cancer patients with mood disorders is 57% higher ( = 0.0109). Moreover, the weighted total expenditures for outpatient visits in prostate cancer patients with mood disorders is 93% higher ( = 0.0001). The potential predictor in total healthcare expenditures is perceived health status (fair/poor) ( = 0.0066).
Individuals with a diagnosis of mood disorders were found to have higher average healthcare expenditures in emergency room visits than those without mood disorders. Therefore, the implications of this study are to inform the patient care team that the assessment and management of mood disorders is a priority. Moreover, screening of mood- disorder symptoms should occur early to optimize care. Finally, policymakers should provide accessible care to minimize emergency room visits.
应用倾向评分匹配（PSM）比较前列腺癌男性中伴有和不伴有心境障碍诊断的医疗服务利用和支出平均值，并确定与医疗支出增加相关的潜在预测因素。
横断面研究。
应用 PSM 后共确定了 308602 名经加权的前列腺癌患者。从 2010 年至 2015 年的医疗支出面板调查（MEPS）中提取前列腺癌男性的数据。为了形成队列，应用了 1:1 PSM。分析的医疗保健利用和支出包括急诊就诊、住院患者住院天数、门诊就诊、门诊就诊和处方。使用具有伽马分布和对数链接的广义线性模型来确定哪些协变量与每种医疗服务的医疗保健支出增加相关。
前列腺癌伴心境障碍患者和无心境障碍患者的急诊就诊平均支出分别为 3092.34 美元和 1330.64 美元（ = 0.038）。心境障碍前列腺癌患者急诊就诊的加权总支出高 57%（ = 0.0109）。此外，心境障碍前列腺癌患者的门诊就诊加权总支出高 93%（ = 0.0001）。总医疗保健支出的潜在预测因素是感知健康状况（差/差）（ = 0.0066）。
与无心境障碍的患者相比，心境障碍诊断患者的急诊就诊平均医疗支出更高。因此，本研究的意义在于告知患者护理团队，评估和管理心境障碍是优先事项。此外，应尽早进行心境障碍症状筛查，以优化护理。最后，政策制定者应提供可及的护理，以尽量减少急诊就诊。
