Association between depression, anxiety and long-term healthcare resource utilization in patients with pulmonary embolism

Abstract

Background

To date, the utilization of healthcare resources for complications associated with acute pulmonary embolism (PE) have received no attention. This study aimed to explore healthcare utilization and its association with depression and anxiety up to 2 years after in-patient treatment for PE.

Methods

Data from the German ‘Lungenembolie Augsburg (LEA)' cohort study was used. Baseline characteristics of the adult patients with PE were collected through an interview during hospital stay and via chart review. Participants completed postal questionnaires 3, 6, 12, and 24 months after their PE event containing questions on healthcare utilization. Depression and anxiety were assessed using the Hospital Anxiety and Depression scale (HADS-D). Negative binomial mixed models were used to investigate the associations between depression and anxiety scores (exposures) and the number of hospitalizations, hospital outpatient clinic visits, general practitioner consultations and medical specialist visits with outcomes adjusted for potential confounders.

Results

Out of 569 patients (55 % male, mean age 63.0 ± 14.5 years), 18.3 % had at least mild symptoms of depression and 21.3 % had at least mild symptoms of anxiety at the initial hospitalization. During the first 3 months after hospital discharge, 28.1 % of the patients had at least one hospital readmission. Higher HADS-D depression scores were significantly associated with more hospitalizations (p = 0.0063), hospital outpatient clinic visits (p = 0.0009) and visits to general practitioners (p = 0.0434). Higher HADS-D anxiety scores were significantly associated with more hospitalizations (p = 0.0413) and visits to medical experts (p = 0.0268).

Conclusions

Depression and anxiety were significantly associated with increased healthcare utilization in patients with PE.