Livingston G, Manela M, Katona C
University College London Medical School.
Br J Psychiatry. 1997 Jul;171:56-9. doi: 10.1192/bjp.171.1.56.
There has been no published study that considers actual costs in a representative sample of people aged > or = 65 years. The present study describes the financial costs of formal community services for elderly people with dementia, depression, anxiety disorder or physical disability.
Psychiatric morbidity, physical disability and services received were assessed by standardised questionnaire in randomly selected Islington enumeration districts. Subjects were interviewed at home (n = 700).
Dementia was the most expensive disorder per sufferer in terms of formal services. Those with depression were also high users of health services. Despite presenting to health services, 90% were not treated with appropriate drugs. In contrast, social services were received by people who were activity-limited or with dementia. The highest service cost for the population as a whole was for the physically disabled. In multivariate analysis the significant predictors of high service costs were living alone, being physically ill, depression, dementia and increasing age.
Failure to detect and treat depression and the anxiety disorders in older people, despite their presentation to medical services, may have major economic consequences as well as contributing to individual suffering.
尚无已发表的研究考虑年龄≥65岁的代表性样本中的实际成本。本研究描述了为患有痴呆症、抑郁症、焦虑症或身体残疾的老年人提供正规社区服务的财务成本。
通过标准化问卷对随机选择的伊斯灵顿普查区的精神疾病发病率、身体残疾情况和所接受的服务进行评估。在家中对受试者进行访谈（n = 700）。
就正规服务而言，痴呆症是每位患者最昂贵的疾病。抑郁症患者也是医疗服务的高使用者。尽管前往医疗服务机构就诊，但90%的患者未接受适当药物治疗。相比之下，活动受限者或患有痴呆症者接受了社会服务。总体人群中最高的服务成本是针对身体残疾者。在多变量分析中，高服务成本的显著预测因素是独居、身体疾病、抑郁症、痴呆症和年龄增长。
尽管老年人前往医疗服务机构就诊，但未能检测和治疗抑郁症及焦虑症可能会产生重大经济后果，并导致个人痛苦。
