台湾地区有或无共病抑郁的痴呆症患者的医疗保健利用情况：一项基于全国人口的纵向研究。

Health-care utilization among dementia patients with or without comorbid depression in Taiwan: A nationwide population-based longitudinal study.

机构信息

Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.

Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.

出版信息

Int J Geriatr Psychiatry. 2023 Feb;38(2):e5889. doi: 10.1002/gps.5889.

DOI:10.1002/gps.5889

PMID:36773286

Abstract

BACKGROUND

Few studies have examined the association of comorbid depression with health-care utilization among dementia patients. This study compared health-care utilization between dementia patients with and without comorbid depression.

METHODS

Using Taiwan's National Health Insurance Research Database, we identified 10,710 patients with newly diagnosed dementia between 2005 and 2014: 1785 had comorbid depression (group 1) and 8925 did not (group 2). Patients were tracked for 1 year to evaluate outpatient, emergency, and inpatient service utilization and length of hospital stay (LOS). Multivariable regression was applied to examine the association between comorbid depression and health-care utilization and analyze factors associated with inpatient visits and LOS.

RESULTS

Group 1 had significantly fewer outpatient visits (β = -0.115; p < 0.001), more inpatient visits (β = 0.157; p = 0.005), and a longer LOS (β = 0.191; p < 0.001) than did group 2. The groups did not differ significantly in emergency visits (β = 0.030; p = 0.537). In group 1, age, gender, and specific comorbidities were predictors of inpatient visits; those factors and salary-based insurance premiums were predictors of LOS.

CONCLUSION

Group 1 utilized less outpatient care but more inpatient care, suggesting health-care service for these patients may be needed to improvement.

摘要

背景

鲜有研究调查共病抑郁与痴呆患者医疗保健利用之间的关系。本研究比较了共病抑郁与无共病抑郁的痴呆患者的医疗保健利用情况。

方法

使用台湾全民健康保险研究数据库，我们在 2005 年至 2014 年间确定了 10710 例新诊断的痴呆患者：1785 例有共病抑郁（第 1 组），8925 例无共病抑郁（第 2 组）。对患者进行了为期 1 年的跟踪，以评估门诊、急诊和住院服务的利用情况以及住院时间（LOS）。多变量回归用于检验共病抑郁与医疗保健利用之间的关系，并分析与住院就诊和 LOS 相关的因素。

结果

第 1 组的门诊就诊次数明显减少（β=-0.115；p<0.001），住院就诊次数更多（β=0.157；p=0.005），住院时间更长（β=0.191；p<0.001）。两组急诊就诊次数无显著差异（β=0.030；p=0.537）。在第 1 组中，年龄、性别和特定的共病是住院就诊的预测因素；这些因素以及基于工资的保险费是 LOS 的预测因素。