Journal Information
Vol. 32. Issue 6.
Pages 309-314 (January 2008)
Vol. 32. Issue 6.
Pages 309-314 (January 2008)
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Morbidity and costs associated with depressive syndrome in stroke sufferers in a population
Morbilidad y costes asociados al síndrome depresivo en sujetos con ictus en un ámbito poblacional
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A. Sicras Mainara,
Corresponding author
asicras@bsa.cat

Correspondence: Dirección de Planificación. Badalona Serveis Assistencials. C. Gaietà Soler, 6-8 entlo. 08911 Badalona. Barcelona. España.
, R. Navarro Artiedab, M. Blanca Tamayoc, J. Rejas Gutiérrezd, J. Fernández de Bobadillae
a Dirección de Planificación, Badalona Serveis Asistencials, Badalona, Barcelona, Spain
b Servicio de Documentación Médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
c Servicio de Psiquiatría, Badalona Serveis Asistencials, Badalona, Barcelona, Spain
d Health Outcomes Research, Unidad Médica, Pfizer, S.A. Madrid, Spain
e Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
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Abstract
Objective

To measure morbidity and the associated costs of depressive disorders (DD) in subjects who have had a stroke in a population treated by primary care settings under usual clinical practice conditions.

Method

Cross-sectional, retrospective studies. Adult stroke patients with DD were included in the study, and treated by 5 primary care settings (PCS) during 2006. A comparative group was formed with the rest of non-DD patients. The main measurements taken were: age, sex, history/co-morbidity, Charlson index, clinical parameters, and corresponding outpatient costs; drugs, diagnostic tests, referrals, and visits. Multiple logistic regression analysis and ANCOVA were used to correct the models.

Results

A total of 2566 stroke patients were assessed. Seventeen point seven percent (95% CI, 16.2–19.2) were identified as having DD; average age, 69.5 years (standard deviation, 12.6); 57.2% of those were female. In the correction of the model, females (OR, 2.1), obesity (OR, 1.1), and neuropathy (OR, 2.2), were significantly associated with DD in stroke patients. The adjusted total costs of DD were higher in most components, e2037.55 versus e1498.24, P<.001. Seventy three point four percent of the total cost was drugs-derived.

Conclusions

Prevalence of DD was higher in stroke patients, and was more associated with females, obesity, and neuropathy. The patient cost is high and patients use more health resources.

Keywords:
Depressive disorders
Stroke
Cost
Resumen
Objetivo

Medir la morbilidad y los costes asociados al síndrome depresivo (SD) en sujetos con ictus en población atendida por equipos de atención primaria y en condiciones de práctica clínica habitual.

Método

Estudio transversal de carácter retrospectivo. Se incluyeron pacientes adultos con presencia de ictus y de SD atendidos por 5 equipos de atención primaria durante el año 2006. Se formó una cohorte comparativa con el resto de pacientes sin SD. Las principales medidas fueron: edad, sexo, historial/comorbilidad, índice de Charlson, parámetros clínicos y costes totales (visitas, pruebas complementarias, derivaciones y medicamentos). Se efectuó un análisis de regresión logística y de ANCOVA para la corrección de los modelos.

Resultados

El total de pacientes atendidos con ictus fue de 2.566. Un 17,7% (intervalo de confianza del 95%, 16,2–19,2%) se identificaron con SD; promedio de edad: 69,5 años (desviación estándar: 12,6); el 57,2% eran mujeres. En la corrección del modelo, el sexo femenino (odds ratio [OR]: 2,1), la obesidad (OR: 1,1) y las neuropatías (OR: 2,2) se asociaron significativamente al SD en sujetos con ictus. Los costes totales ajustados del SD fueron superiores en la mayoría de sus componentes, 2.037,55 € frente a 1.498,24 €, p<0,001. El 73,4% de los costes se derivó de los medicamentos.

Conclusiones

La prevalencia del SD en sujetos con ictus es elevada, se asocia al sexo femenino y a la presencia de obesidad y neuropatías. Los costes de estos pacientes son altos y ocasionan un elevado consumo de recursos sanitarios.

Palabras clave:
Síndrome depresivo
Ictus
Coste
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