Depression and Health Service Use After Heart Attack
Author Information
Author(s): Kurdyak Paul A, Gnam William H, Goering Paula, Chong Alice, Alter David A
Primary Institution: Institute for Clinical Evaluative Sciences (ICES)
Hypothesis
Health service consumption following AMI would be increased among patients with depressive symptoms as compared to those without and would be independent of comorbidity and cardiac illness severity.
Conclusion
Depressive symptoms are associated with significantly higher cardiac and non-cardiac health service consumption following AMI despite adjustments for comorbidity and prognostic severity.
Supporting Evidence
- Depressive symptoms were associated with a 24% increase in total hospitalization days post-AMI.
- Patients with depressive symptoms had higher rates of cardiology and family practice visits.
- The relationship between health service consumption and depressive symptoms persisted after adjusting for comorbidity.
Takeaway
People who feel very sad after a heart attack tend to go to the doctor more often, even if they aren't sicker than others.
Methodology
Prospective cohort study with follow-up telephone interviews of patients discharged from hospitals after AMI.
Potential Biases
Potential survival bias due to measuring depression at one month post-AMI.
Limitations
Depressive symptoms were measured at one month post-AMI, which may not reflect long-term depression; missing data for over 30% of the population.
Participant Demographics
Median age was 64 years; 29.6% were women.
Statistical Information
P-Value
P < 0.001
Confidence Interval
95% CI:1.19–1.30
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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