BACKGROUND Little is known about the effects of changes in the presence or absence of psychiatric disorders on health care utilization in multiple sclerosis (MS). OBJECTIVE To evaluate the association between "active" mood and anxiety disorders (MAD) and health care utilization in MS. METHODS Using administrative data from Manitoba, Canada, we identified 4748 persons with MS and 24,154 persons without MS matched on sex, birth year, and region. Using multivariable general linear models, we evaluated the within-person and between-person effects of any "active" MAD on annual physician visits, hospital days, and number of drug classes dispensed in the following year. RESULTS Annually, the MS cohort had an additional two physician visits, two drug classes, and nearly two more hospital days versus the matched cohort. Individuals with any MAD had more physician visits, had hospital days, and used more drug classes than individuals without a MAD. Within individuals, having an "active" MAD was associated with more utilization for all outcomes than not having an "active" MAD, but the magnitude of this effect was much smaller for visits and drugs than the between-person effect. CONCLUSION Within individuals with MS, changes in MAD activity are associated with changes in health services use.

中文翻译：

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情绪和焦虑障碍对多发性硬化患者医疗保健利用的影响

背景 关于精神障碍的存在与否的变化对多发性硬化症 (MS) 中医疗保健利用的影响知之甚少。目的 评估 MS 中“积极”情绪和焦虑症 (MAD) 与医疗保健利用之间的关联。方法 使用来自加拿大曼尼托巴省的行政数据，我们确定了 4748 名 MS 患者和 24,154 名非 MS 患者的性别、出生年份和地区匹配。使用多变量一般线性模型，我们评估了任何“活跃”MAD 对年度就诊、住院天数和次年配药种类数量的人内和人际影响。结果 每年，与匹配队列相比，MS 队列增加了两次医生就诊次数、两种药物类别以及近两天的住院天数。与没有 MAD 的人相比，患有任何 MAD 的人有更多的医生就诊次数、住院天数和使用的药物种类更多。在个体中，与没有“活跃”的 MAD 相比，拥有“活跃”的 MAD 与所有结果的利用率更高有关，但这种影响的程度对于就诊和药物而言比人际效应小得多。结论 在 MS 患者中，MAD 活动的变化与卫生服务使用的变化有关。但是这种效应对于探视和药物的影响比人与人之间的效应要小得多。结论 在 MS 患者中，MAD 活动的变化与卫生服务使用的变化有关。但是这种效应对于探视和药物的影响比人与人之间的效应要小得多。结论 在 MS 患者中，MAD 活动的变化与卫生服务使用的变化有关。