Abstract

Objectives

To compare the averages of healthcare services utilization and of expenditures for men with prostate cancer with and without diagnoses of mood disorders applying propensity score matching (PSM), and to identify the potential predictors associated with increased healthcare expenditures.

Design

Cross-sectional study.

Sample and methods

A total of 308,602 weighted patients with prostate cancer were identified after applying PSM. The datasets for men with prostate cancer were extracted from the Medical Expenditure Panel Survey (MEPS) from 2010 to 2015. For cohort formation, 1:1 PSM was applied. Healthcare utilization and expenditures analyzed included emergency room visits, length of stay for hospital inpatients, outpatient visits, office-based visits, and prescriptions. Generalized linear model with gamma distribution and log link was used to determine which covariates are associated with the increase in healthcare expenditures for each healthcare service.

Findings

The mean expenditures for emergency room visits between men with prostate cancer and mood disorders was $3,092.34, and it was $1,330.64 for patients without mood disorders (p = 0.038). The weighted total expenditures for emergency room visits in prostate cancer patients with mood disorders is 57% higher (p = 0.0109). Moreover, the weighted total expenditures for outpatient visits in prostate cancer patients with mood disorders is 93% higher (p = 0.0001). The potential predictor in total healthcare expenditures is perceived health status (fair/poor) (p = 0.0066).

Conclusions and Implications for Psychosocial Providers or Policy

Individuals with a diagnosis of mood disorders were found to have higher average healthcare expenditures in emergency room visits than those without mood disorders. Therefore, the implications of this study are to inform the patient care team that the assessment and management of mood disorders is a priority. Moreover, screening of mood- disorder symptoms should occur early to optimize care. Finally, policymakers should provide accessible care to minimize emergency room visits.

中文翻译：

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美国患有和不患有情绪障碍的前列腺癌患者的医疗保健服务支出：一项倾向评分匹配的横断面研究

摘要

目标

使用倾向评分匹配 (PSM) 比较诊断出和未诊断出情绪障碍的前列腺癌男性的医疗保健服务利用率和支出的平均值，并确定与医疗保健支出增加相关的潜在预测因素。

设计

横断面研究。

样品和方法

应用 PSM 后，共确定了 308,602 名加权前列腺癌患者。前列腺癌男性数据集是从 2010 年至 2015 年的医疗支出面板调查 (MEPS) 中提取的。对于队列形成，应用了 1:1 PSM。分析的医疗保健利用和支出包括急诊室就诊、住院患者的住院时间、门诊就诊、办公室就诊和处方。使用具有伽马分布和对数链接的广义线性模型来确定哪些协变量与每个医疗保健服务的医疗保健支出增加相关。

发现

患有前列腺癌和情绪障碍的男性急诊室就诊的平均支出为 3,092.34 美元，而没有情绪障碍的患者则为 1,330.64 美元（p  = 0.038）。患有情绪障碍的前列腺癌患者急诊室就诊的加权总支出高出 57% ( p  = 0.0109)。此外，患有情绪障碍的前列腺癌患者门诊就诊的加权总支出高出 93% ( p  = 0.0001)。总医疗保健支出的潜在预测因素是感知的健康状况（一般/差）（p  = 0.0066）。

结论和对社会心理服务提供者或政策的影响

发现患有情绪障碍的人在急诊室就诊时的平均医疗保健支出高于没有情绪障碍的人。因此，本研究的意义在于告知患者护理团队，情绪障碍的评估和管理是当务之急。此外，应尽早筛查情绪障碍症状以优化护理。最后，政策制定者应提供无障碍护理，以尽量减少急诊室就诊。