우울증 환자의 외래진료 민감 질환으로 인한 입원의 위험 평가: 전국 인구 기반 연구

다국어 초록 (Multilingual Abstract)

OBJECTIVE Ambulatory care sensitive conditions (ACSC) refer to conditions such as diabetes and hypertension that can be effectively treated in outpatient settings. We evaluated the impact of depression on primary care outcomes by assessing the risk of hospitalization for ACSC (H-ACSC) in patients with depression. METHODS We utilized the 2018 Health Insurance Review and Assessment Service-National Patients Sample (HIRA-NPS) data. Patients with depression were defined as those with at least two claim records with a primary diagnosis of depression (International Classification of Diagnosis (ICD)-10th codes: F32-F33) or prescription of antidepressants. Patients without depression were those without claim records and prescription . The hospitalization rate of ACSC was compared between these two groups. RESULTS About 1.38% (n=13,653) of adult patients from the 2018 HIRA-NPS had depression. Patients with depression had about two times higher risk of H-ACSC (adjusted odds ratio (aOR): 1.992, 95% confidence interval (CI): 1.775-2.235) than those without depression. Among those experiencing H-ACSC, patients with depression had 1.184 times more inpatients days per year (aOR: 1.184, 95% CI: 1.060-1.323) and 1.472 times higher chances of having total annual inpatient days more than the 75 percentile of the patients hospitalized with ACSC (aOR: 1.472, 95% CI: 1.159-1.871). Respiratory, circulatory, and genitourinary diseases accounted for 80% of H-ACSC cases across both groups among the eight ACSC diseases analyzed. CONCLUSION Our analysis confirms that depression is associated with an elevated risk of H-ACSC. Without proper monitoring of depression in ACSC patients, the effectiveness of primary care in managing ACSC may be compromised.