Pain and Healthcare Utilization in Middle-aged and Elder patients with Depression

• Main Authors: Yu-Pei, Chen, 陳毓珮
• Other Authors: Ling-Ling, Yeh
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/fxq974

碩士 === 亞洲大學 === 健康產業管理學系長期照護組 === 100 === Objective: The elderly people with depression and pain have attracted an increasing attention. Rare study explored physical and mental illness related to pain for depression patients and middle-aged groups who are getting old in Taiwan. Therefore, this study aimed to explore physical pain on middle-aged and elderly patients with depression, and further detected the factors related to physical illness such as pain, as well as the medical utilization and expenses imposed on patients with depression. Method: This study employed the claim dataset of National Health Insurance from National Health Research Institutes. Patients had the first diagnosis of depressive disorder（ICD-9-CM code 296.2、296.3、300.4、311）and taking anti-depressant in 2003 as the study subjects. After determining study subjects, this study explored physical pain, physical illness and mental illness the patients suffering from, and analyzes medical utilization treatment and expenses in a year. Results: The number of study subjects in this study is 136,051 in which 84.4% middle-aged and aged depression patients suffer from physical pain. The average number of pains suffered by depression patients is 2.97, and common pains occur on head（53.2%）, gastric ulcer and gastritis（50.1%） and joint（45.3%）. Depression patients with one year history of mental illness positively correlative to pain such as physical illness（OR=6.0）, newly diagnosed depression（OR=1.1）, CVD（OR=1.8）, COPD （OR=1.8）and high cholesterol（OR=1.6） have higher probability of physical pain. It showed that middle-aged and elderly patients with depression had physical pain once sought medical service at non-psychiatric outpatient and emergency for about 23 times more than patients with no physical pain, with also 17,564 points higher for their total medical expenses in non-psychiatric emergency department, slightly 0.18 times higher for hospitalization, but related 58,185 points lower in terms of the expense of hospitalization. Conclusions: This study revealed that patients with depression had concurrent mental illness positively correlative to physical illness and pain have higher ratio of chief complaint of physical pain, and use more medical resources related to non-psychiatry. It is suggested for medical service providers to pay more attention to depression mentioned above, take the possibility of physical pains into consideration and provide appropriate treatment.