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Association of mental distress with health care utilization and costs: a 5-year observation in a general population

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Abstract

Objective

Previous studies have associated mental distress and disorders with increased health care utilization and costs. However, most studies have selected subjects from treatment facilities or have applied retrospective designs.

Methods

N = 3,300 subjects from the baseline cohort of the Study of Health in Pomerania were followed up 5 years later. Mental distress was assessed with the SF-12 Health Survey and the Composite Diagnostic Screener for mental disorders. Two-part econometric models were applied adjusting for medical confounders and baseline services use.

Results

At 5-year follow-up somatization at baseline predicted an increase of inpatient (+39.9%) and outpatient costs (+11.9%). Depression predicted an increase of inpatient (+24.1%) and outpatient costs (+8.9%). Comorbidity of somatization and depression and somatization and anxiety predicted an increase in overall health care costs of ≥50%.

Conclusion

Simple and time-efficient screening procedures for mental disorders may help to identify subjects at risk for increased future health care utilization. Standardized therapeutic interventions should be evaluated in subjects at risk in primary care.

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Acknowledgments

The work is part of the Community Medicine Research Net (CMR) of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant no. ZZ 96030). The funder did not influence the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The CMR encompasses several research projects which are sharing data of population-based Study of Health in Pomerania (SHIP, http://www.medizin.uni-greifswald.de/cm). We are also appreciative for the advice issued in statistical modelling of health care utilization and costs from Dr. Susan L. Ettner, Division of General Internal Medicine and Health Services Research, UCLA Department of Medicine, Los Angeles, CA, USA, and members of the ATS statistical consulting group at UCLA, Los Angeles, CA, USA.

Conflict of interest statement

There are no conflicts of interest (HJG, SEB, UJ, HJF, HV).

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Correspondence to Hans Jörgen Grabe.

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Grabe, H.J., Baumeister, S.E., John, U. et al. Association of mental distress with health care utilization and costs: a 5-year observation in a general population. Soc Psychiat Epidemiol 44, 835–844 (2009). https://doi.org/10.1007/s00127-009-0005-9

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  • DOI: https://doi.org/10.1007/s00127-009-0005-9

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