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Perceived burden of illness in patients entering for treatment in a university hospital – is the threshold to secondary care higher for patients with depression than for those with somatic disorders?

Published online by Cambridge University Press:  16 April 2020

K. Suominen ,
H. Karlsson ,
A. Rissanen ,
H.M. Valtonen ,
P. Räsänen ,
H. Sintonen  and
R.P. Roine
K. Suominen*
Affiliation:
Helsinki University Central Hospital, Department of Psychiatry, Jorvi Hospital, PO Box 800, 00029 HUS, Finland
H. Karlsson
Affiliation:
Helsinki University Central Hospital, Department of Psychiatry, Jorvi Hospital, PO Box 800, 00029 HUS, Finland
A. Rissanen
Affiliation:
Helsinki and Uusimaa Hospital District, Group Administration/Research and Development, PO Box 705, 00029 HUS, Finland
H.M. Valtonen
Affiliation:
Helsinki University Central Hospital, Department of Psychiatry, Jorvi Hospital, PO Box 800, 00029 HUS, Finland
P. Räsänen
Affiliation:
Helsinki and Uusimaa Hospital District, Group Administration/Research and Development, PO Box 705, 00029 HUS, Finland Finnish Office for Health Technology Assessment, PO Box 30, 00271, Helsinki, Finland
H. Sintonen
Affiliation:
University of Helsinki, Hjelt Institute, Department of Public Health, University of Helsinki, PO Box 41, 00014Helsinki, Finland
R.P. Roine
Affiliation:
Helsinki and Uusimaa Hospital District, Group Administration/Research and Development, PO Box 705, 00029 HUS, Finland
*
*Corresponding author. E-mail address: [email protected] (K. Suominen).
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Abstract

Background

The threshold to secondary health care should be similar for all patients independent of the underlying disease. This study compared, using a validated health-related quality of life (HRQoL)-instrument, whether the perceived burden of illness is similar in patients admitted for secondary care treatment into a university hospital because of one of six common conditions.

Methods

HRQoL, assessed by the generic 15D instrument before elective treatment, was compared in six groups: operative treatment of cataract (n = 219), operative treatment of cervical or lumbar radicular pain (n = 270), hysterectomy due to benign uterine conditions (n = 337), hip or knee replacement surgery (n = 223), coronary angiography due to suspected coronary artery disease (n = 261), and secondary care treatment of depression (n = 89).

Results

Mean (±SD) HRQoL score was clearly highest in patients with benign uterine conditions (0.908 ± 0.071) and lowest in patients with depression (0.729 ± 0.120) (P < 0.001 between the groups). Also all the other groups had a significantly (P < 0.001) higher baseline HRQoL score (ranging from 0.802 to 0.824) than patients with depression. Outcome of treatment, in terms of HRQoL improvement, was in depressive patients at least equal, and in some cases even better, than that in the other groups.

Discussion

Our results imply that, at least concerning perceived burden of illness, patients with depression are worse off when admitted to secondary care treatment than patients with many somatic conditions. That may be a consequence of poor motivation of depressive patients to seek treatment or that, contradictory to guidelines, the health care system does nor give priority to those worst off and sets a higher threshold for specialized care of patients with depression than of those with common somatic disorders.

Keywords

DepressionHealth-related quality of lifeBurden of diseaseEquity15D
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 7 , October 2011 , pp. 441 - 445
Copyright
Copyright © Elsevier Masson SAS 2010

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