Document Detail

Depression and risk of hospitalizations for ambulatory care-sensitive conditions in patients with diabetes.
MedLine Citation:
PMID:  23325384     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hospitalizations for ambulatory care-sensitive conditions (ACSCs), conditions that should not require inpatient treatment if timely and appropriate ambulatory care is provided, may be an important contributor to rising healthcare costs and public health burden.
OBJECTIVE: To examine if probable major depression is independently associated with hospitalization for an ACSC in patients with diabetes.
DESIGN: Secondary analysis of data from a prospective cohort study.
PARTICIPANTS: Population-based cohort of 4,128 patients with diabetes ≥ 18 years old seen in primary care, who were enrolled between 2000 and 2002 and followed for 5 years (through 2007).
MAIN MEASURES: Depressive symptoms were assessed with the Patient Health Questionnaire-9. Outcomes of interest included time to initial hospitalization for an ACSC and total number of ACSC-related hospitalizations. We used Cox proportional hazards regression models to ascertain an association between probable major depression and time to ACSC-related hospitalization, as well as Poisson regression for models examining probable major depression and number of ACSC-related hospitalizations.
KEY RESULTS: Patients' mean age at study enrollment was 63.4 years (Standard Deviation: 13.4 years). Over the 5-year follow-up period, 981 patients in the study were hospitalized a total of 1,721 times for an ACSC, comprising 45.1 % of all hospitalizations. After adjusting for baseline demographic, clinical and health-risk behavioral factors, probable major depression was associated with initial ACSC-related hospitalization (Hazard Ratio: 1.41, 95 % Confidence Interval [95 % CI]: 1.15, 1.72) and number of ACSC-related hospitalizations (Relative Risk: 1.37, 95 % CI: 1.12, 1.68).
CONCLUSIONS: Probable major depression in patients with diabetes is independently associated with hospitalization for an ACSC. Additional research is warranted to ascertain if effective interventions for depression in patients with diabetes could reduce the risk of hospitalizations for ACSCs and their associated adverse outcomes.
Dimitry S Davydow; Wayne J Katon; Elizabeth H B Lin; Paul Ciechanowski; Evette Ludman; Malia Oliver; Michael Von Korff
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2013-01-17
Journal Detail:
Title:  Journal of general internal medicine     Volume:  28     ISSN:  1525-1497     ISO Abbreviation:  J Gen Intern Med     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-14     Completed Date:  2014-02-19     Revised Date:  2014-07-01    
Medline Journal Info:
Nlm Unique ID:  8605834     Medline TA:  J Gen Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  921-9     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Ambulatory Care / methods,  trends*
Cohort Studies
Depressive Disorder, Major / diagnosis,  psychology*,  therapy*
Diabetes Mellitus / diagnosis,  psychology*,  therapy*
Follow-Up Studies
Hospitalization / trends*
Middle Aged
Prospective Studies
Grant Support
Comment In:
J Gen Intern Med. 2013 Jul;28(7):951   [PMID:  23423455 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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