Comparison of overall survival and healthcare resource utilization among patients with major depressive disorder with or without psychiatric emergency admission: A real-world study from Hungary

IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY
Zoltan Rihmer , Peter Dome , Gyorgy Szekeres , Laszlo Feher , Peter Kunovszki , Judit Gimesi-Orszagh , Qian Cai , Antoine C. El Khoury , Istvan Bitter
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Abstract

Background

Patients with major depressive disorder (MDD) hospitalized for psychiatric emergencies (PE) represent a high-risk population, requiring immediate intervention. Overall survival and healthcare resource utilization were evaluated among MDD patients with PE (MDD-PE) vs without PE (MDD-nonPE) using data from the Hungarian National Health Insurance Fund database (2009 to 2020).

Methods

Patients with MDD were selected if they had at least (i) 2 records of MDD diagnosis, or (ii) 1 record of MDD diagnosis and 1 prescription of antidepressant within 90 days of each other between 01 January 2010 and 31 December 2020. MDD-PE patients should have an inpatient hospitalization in a psychiatric ward dedicated for acute treatment, and/or a visit to an emergency department with ≥1 psychiatric and/or suicidal condition among the discharge diagnoses. Patients in the MDD-PE and MDD-nonPE cohorts were matched using a 1:1 propensity score matching algorithm based on age, gender, location of residence, and selected pre-index comorbidities.

Results

28,988 MDD-PE and 28,988 MDD-nonPE patients were included after propensity score matching. Overall survival was significantly shorter among MDD-PE vs matched MDD-nonPE patients (HR: 1.40, 95%CI: 1.33–1.48; p < 0.001). MDD-PE (vs matched MDD-nonPE) patients had significantly higher mean all-cause inpatient admissions (3.9 vs 1.4, p < 0.001) per patient per year (PPPY), and MDD-related inpatient admissions (2.3 vs 0.7, p < 0.001) PPPY with more days in hospital PPPY (all-cause: 65.4 vs 17.4 days; MDD-related: 25.9 vs 8.7 days).

Conclusions

Findings emphasize the need for comprehensive care prioritizing increased vigilance for suicide risk and appropriate follow-up post-discharge among MDD-PE patients.
有或没有精神科急诊住院的重度抑郁症患者的总生存率和医疗资源利用的比较:来自匈牙利的一项现实世界研究
背景:重度抑郁障碍(MDD)患者因精神急诊(PE)住院是高危人群,需要立即干预。使用匈牙利国家健康保险基金数据库(2009年至2020年)的数据,评估患有PE (MDD-PE)与无PE (MDD-非PE)的MDD患者的总生存期和医疗资源利用率。方法:选取在2010年1月1日至2020年12月31日期间间隔90 天内至少有2次MDD诊断记录,或1次MDD诊断记录和1次抗抑郁药物处方的MDD患者。MDD-PE患者应在专门用于急性治疗的精神科病房住院,和/或在出院诊断中有≥1种精神和/或自杀状况的急诊科就诊。MDD-PE组和mdd -非pe组的患者根据年龄、性别、居住地和选定的指数前合并症,使用1:1的倾向评分匹配算法进行匹配。结果:倾向评分匹配后纳入28,988例MDD-PE和28,988例mdd -非pe患者。MDD-PE患者的总生存期明显短于匹配的mdd -非pe患者(HR: 1.40, 95%CI: 1.33-1.48;p 结论:研究结果强调需要综合护理,优先提高MDD-PE患者自杀风险的警惕性,并在出院后进行适当的随访。
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来源期刊
Journal of affective disorders
Journal of affective disorders 医学-精神病学
CiteScore
10.90
自引率
6.10%
发文量
1319
审稿时长
9.3 weeks
期刊介绍: The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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