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Published on: May 22, 2019
Association between post-stroke depressiveness and the utilization of healthcare services three months after the
Raphaela Artner1,2,3, Christine Meisinger3, Michael Ertl4
1Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, LMU Munich, Munich, Germany.
Insights
Post-stroke depression significantly increases healthcare service use, including hospital stays and rehabilitation. Understanding this link is vital for managing stroke survivor care and healthcare resource allocation.
Area of Science:
- Neurology
- Psychiatry
- Health Services Research
Background:
- Post-stroke depression (PSD) affects about one-third of stroke survivors, leading to adverse outcomes.
- Rising stroke prevalence necessitates understanding PSD's impact on healthcare utilization.
Purpose of the Study:
- To examine the association between patient-reported post-stroke depressiveness and healthcare service utilization three months post-stroke.
Main Methods:
- Prospective Stroke Cohort Augsburg (SCHANA) study.
- Assessed post-stroke depressiveness using the Patient Health Questionnaire (PHQ-9) during hospitalization.
- Collected data on medical, therapeutic, rehabilitation, and inpatient services utilization three months post-discharge.
- Employed multivariable adjusted linear and binary logistic regression analyses.
Main Results:
- Higher PHQ-9 scores correlated with increased likelihood of inpatient hospital treatment (OR=1.07).
- Higher PHQ-9 scores correlated with increased attendance at rehabilitation programs (OR=1.09).
- Higher PHQ-9 scores correlated with more frequent utilization of general practitioners/internists (beta=0.10).
Conclusions:
- Post-stroke depressiveness is significantly associated with increased healthcare service utilization.
- Further research is needed for a comprehensive understanding of PSD's healthcare impact.
Abstract:
Post-stroke depression affects approximately one-third of stroke survivors and can result in various adverse outcomes. With the rising prevalence of strokes, understanding the impact of post-stroke depression on healthcare utilization is crucial. The study examined the association between patient-reported post-stroke depressiveness and the healthcare service utilization three months post-stroke. The prospective Stroke Cohort Augsburg (SCHANA) study assessed post-stroke depressiveness using the Patient Health Questionnaire (PHQ-9) during hospital stay. Participants reported their utilization of medical and therapeutic services, rehabilitation, and inpatient hospital stays three months post-discharge. Multivariable adjusted linear and binary logistic regression analyses examined the association between post-stroke depressiveness and healthcare service utilization. Among 546 participants included into the analyses, 57.1% had no depression, 28.8% had mild depression and 14.9% had moderate to severe depression. Higher PHQ-9 scores were associated with a significantly increased likelihood of inpatient hospital treatment (OR = 1.07; 95% CI: 1.01-1.14; p = 0.016), attendance at rehabilitation programs (OR = 1.09; 95% CI: 1.03-1.15; p = 0.003), and more frequent utilization of general practitioners/internists (beta = 0.10; 95% CI: 0.01-0.19; p = 0.036). In conclusion, post-stroke depressiveness was associated with increased healthcare service utilization. Further studies are required to gain a more comprehensive understanding.
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