Data for hospital utilization at 30, 60, and 90 days are cumulative.Poisson models were used to test for significant differences between the predicted and observed number of hospitalization events at 30 days. Depression is common, affecting 13% to 16% of people in the US, and is recognized as an important risk factor for poor outcomes among patients with various chronic illnesses.1719 The mechanisms by which depression can be linked to health outcomes and health service utilization have been studied in age‐specific or disease‐specific cohorts such as cardiac patients or frail elders and include both physiologic factors such as hypercoagulability and hyperinflammatory conditions, as well as behavioral factors such as poor self‐care behaviors and heightened sensitivity to somatic symptoms. (%)45 (9)30 (13)0.130Frequent utilizer,** No. Depression screening: utility of the Patient Health Questionnaire in patients with acute coronary syndrome. Quantitative data on group level showed low anxiety, depression and somatic scores over time. Subjects with Medicaid for insurance had a higher rate of depression (61%) than subjects with Medicare (13%), private insurance (9%), or those who qualified for the Free Care pool (17%) which is the Massachusetts state funding for healthcare to uninsured persons. The unadjusted 30‐day post‐discharge hospital utilization rate among those with depressive symptoms was higher compared with those without symptoms (IRR, 1.90, 95% confidence interval [CI], 1.242.71). Various physiologic and behavioral mechanisms may link symptoms of depression to hospital utilization after discharge. The same method was used to calculate hospital utilization rates within 60 and 90 days of discharge respectively. Indeed, projects to improve the discharge process and post‐hospital care have shown that as much as one‐third of hospital utilization in the month after discharge can be avoided.2 Consequently, the rate of early, unplanned hospital utilization after discharge has emerged as an important indicator of hospital quality and the Centers for Medicare and Medicaid Services (CMS) has proposed a policy to decrease payments to hospitals with high rates of early unplanned hospital utilization. Write down your questions so you remember to ask them during your visits. The chief reason for the young age of our cohort is that potential subjects were excluded if they came from a skilled nursing facility or other hospital. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health. Maybe I'll try holistic medicine. Design. The unadjusted hospital utilization within 30 days of discharge was 56 utilizations per 100 depressed patients compared with 30 utilizations per 100 non‐depressed patients, incident rate ratio (IRR) (confidence interval [CI]), 1.90 (1.51–2.40). Kartha et al.13 reported findings indicating that depression is a risk factor for rehospitalization in general medical inpatients, but the study sample was relatively small and the study design methodology significantly limited its generalizability.12 It would be useful to provide supporting evidence showing depression as an important risk factor for readmission in the general medical in‐patient population using more rigorous study methods and a larger cohort. Thus, there is great interest in identifying modifiable risk factors for rehospitalization that could be used to refine intervention models and lead to improvements in quality of care, patient outcomes, and cost savings.To date, known predictors of readmission include: lower socioeconomic status,3 history of prior hospitalization4 and advanced age,5 length of stay greater than 7 days,6 a high burden of comorbid illnesses (based on Charlson score),7 poor social support,8 and specific diagnoses (eg, congestive heart failure, chronic obstructive pulmonary disease [COPD] and myocardial infarction).5, 9, 10 In addition, unplanned readmissions and emergency department (ED) visits have been linked to polypharmacy and adverse drug events related to treatment with medications such as warfarin, digoxin and narcotics.11, 12 Another characteristic that has also been linked to readmission is depression;13 however5 reports supporting this association are from studies of elderly patients or with patients who have specific diagnoses (eg, congestive heart failure [CHF], COPD, myocardial infarction).1416Depression is common, affecting 13% to 16% of people in the US, and is recognized as an important risk factor for poor outcomes among patients with various chronic illnesses.1719 The mechanisms by which depression can be linked to health outcomes and health service utilization have been studied in age‐specific or disease‐specific cohorts such as cardiac patients or frail elders and include both physiologic factors such as hypercoagulability and hyperinflammatory conditions, as well as behavioral factors such as poor self‐care behaviors and heightened sensitivity to somatic symptoms. Two main types of ketamine are used to treat major depression that hasn’t responded to two or more medications (treatment-resistant depression). In other words, 56 utilization events occurred per 100 patients with depressive symptoms, compared with 30 utilization events per 100 patients without depressive symptoms.
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