Depression and other mental health diagnoses after stroke increase inpatient and outpatient medical utilization three years poststroke

Sushmita Shoma Ghose, Linda S. Williams, Ralph W. Swindle

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Objective: Poststroke depression (PSD) has been linked to negative outcomes, including mortality and decreased functioning. However, the effect of PSD and other mental health conditions on inpatient and outpatient healthcare utilization after stroke has not been examined. The primary objective of this study was to evaluate the relationship between PSD and healthcare utilization after stroke. The secondary objective was to evaluate the relationship between other mental health diagnoses and medical utilization after stroke. Method: We examined 3 years of poststroke healthcare utilization data in a national cohort of veterans with ischemic stroke. Mental health diagnoses were identified with inpatient International Classification of Diseases, 9th Revision codes. Multivariate analysis of variance was used to compare patient characteristics and multivariate linear regression to model utilization in: 1) patients with PSD, 2) patients diagnosed with other mental health conditions poststroke, and 3) patients with no mental health diagnosis. Results: Of 51,119 veterans identified, 2405 (5%) received a PSD diagnosis and 2257 (4%) received a diagnosis of another mental health condition after their stroke. Patients with PSD had significantly more inpatient hospitalization days and outpatient visits than those without any mental health diagnosis, even after adjusting for the number of mental health clinic visits. Likewise, patients diagnosed with other mental health diagnoses had greater medical utilization than patients without any mental health diagnosis. Both PSD and other mental health diagnoses independently predicted medical utilization. Conclusion: Mental health diagnosis after stroke increases inpatient and outpatient healthcare utilization in the first 3 years poststroke. Additional biologic and psychosocial factors should be investigated.

Original languageEnglish (US)
Pages (from-to)1259-1264
Number of pages6
JournalMedical Care
Volume43
Issue number12
DOIs
StatePublished - Dec 1 2005

Fingerprint

stroke
Inpatients
Mental Health
Outpatients
Stroke
utilization
mental health
Depression
Delivery of Health Care
Veterans
psychosocial factors
Biological Factors
International Classification of Diseases
Ambulatory Care
analysis of variance
hospitalization
multivariate analysis
Linear Models
Analysis of Variance
Hospitalization

Keywords

  • Health service utilization
  • Mental disorder & stroke
  • Poststroke depression

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Depression and other mental health diagnoses after stroke increase inpatient and outpatient medical utilization three years poststroke. / Ghose, Sushmita Shoma; Williams, Linda S.; Swindle, Ralph W.

In: Medical Care, Vol. 43, No. 12, 01.12.2005, p. 1259-1264.

Research output: Contribution to journalArticle

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