People suffering from depression are unnecessarily admitted to hospital for physical diseases

Danes suffering from depression are more often admitted to hospital and re-admitted within 30 days for diseases that could be treated by the local health service without hospital admittance than other patient groups. This applies to e.g. high blood pressure, COPD deterioration, worsening of heart failure, diabetes complications, urinary tract infections and pneumonia. 

This is shown by a recent registry study from the research project MEPRICA – Mental Health in Primary Care - at Aarhus University. The study has just been published in the British Medical Journal’s BMJ Open.

The researchers studied what are known as preventable hospitalisations, which are admissions that could possibly have been avoided if prevention and treatment had been optimal, and if the patient in addition had followed doctor's orders in relation to medication etc. The study is based on data collected from five million adults in Denmark in the period 2005-2013, and the conclusion is clear: If a person suffers from depression, their risk of experiencing hospitalisations that could possibly have been avoided with increased resources and new opportunities for collaboration opportunities in the primary and acute sector is greater than for other patients.
At the same time, the large amount of analysed data shows that Danes suffering from depression also have a higher risk of being admitted to hospital again with the same disease within 30 days of being discharged. 

Need for help in daily life

"We know that if you suffer from depression, your life will be shorter – first and foremost because physical diseases in people with depression are often underdiagnosed and undertreated. This study suggests that there is room for improvement in the local health service. We lack good studies that can tell us what needs to be done, but it is probably a case of a complex collaboration between the patient, the patient's network, their own general practitioner, the municipality and medical specialists," says Professor Mogens Vestergaard from MEPRICA.

The study has been carried out in collaboration with senior researcher at Aarhus University, Dimitry P. Davydow from the University of Washington, Seattle. He points out that previous research has shown that increased collaboration between the primary sector and ambulatory efforts in other areas can be both efficient and can save money.

 “So one solution may be to do a better job integrating mental health services into primary-care settings. That way patients with depression can obtain psychiatric care more easily and their mental health care better incorporated into their overall health care,” says Dimitry P. Davydow.

He adds that the lack of access to primary care is unlikely to be the main cause for the increased frequency of hospital admissions because Denmark provides all its citizens with universal health insurance and primary-care access.

• Read the complete study titled ”The Risk for Hospitalizations and Rehospitalizations for Ambulatory Care-Sensitive Conditions in Denmark: a Population-Based Cohort Study”.

Facts:

• More than 1.3 million adult Danes out of the five million who formed the basis of the survey data have been diagnosed with depression by a psychiatrist or have been prescribed antidepressant medicine.
• The Lundbeck Foundation has supported the study via an unrestricted grant.
• MEPRICA (Mental Health in Primary Care) has a well-established collaboration with researchers from the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine in the USA. 

Further information:

Professor, Medical Specialist in General Practice Mogens Vestergaard
Aarhus University, MEPRICA (Mental Health in Primary Care)
Tel.: (+45) 2343 9990
mv@ph.au.dk