Exploring associations between psychiatric disorder, psychological distress, and health care utilization in cancer patients

F.r. Compen, E.m.m. Adang, E.m. Bisseling, M.l. Van Der Lee, A.e.m. Speckens

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective
The mental burden of cancer might elicit additional health care utilization. However, it is unclear how psychiatric disorder and psychological distress relate to health care utilization. Therefore, this study explores associations between psychiatric disorder, psychological distress, and health care utilization. It was hypothesized that presence of psychiatric disorder and psychological distress was associated with increased health care utilization and costs.

Methods
The current study consisted of secondary analyses of baseline data of a larger randomized controlled trial. Two hundred forty‐five mixed‐cancer patients with at least mild symptoms of psychological distress (Hospital Anxiety and Depression Scale–T ≥ 11) were mainly recruited via online media, participating centers and patient associations. Patients were assessed with Structured Clinical Interview for DSM‐IV‐TR Axis I Disorders (SCID‐I) for depressive, anxiety, and/or adjustment disorder. Psychological distress was measured by the Hospital Anxiety and Depression Scale. Retrospective self‐reported health care utilization in the past 3 months was collected. Associations between predictors and health care utilization in terms of incidence rate ratios (IRR) and costs per category (mental, primary, somatic, and complementary) were assessed by negative binomial, logistic, and gamma regression.

Results
Eighty‐nine (36.3%) patients suffered from psychiatric disorder, which was associated with mental health care utilization (IRR = 1.63) and costs (OR = 3.11). We observed a nonsignificant trend of somatic health care utilization in patients with psychiatric disorder. Psychological distress was associated with mental health care utilization (IRR = 1.09) and costs (OR = 1.09). Psychological distress was also associated with complementary health care utilization (IRR = 1.03).

Conclusion
Psychiatric disorder and psychological distress were associated with mental health care use and costs. Psychological distress was associated with complementary health care use. Adequate assessment and referral to mental health care might prevent unnecessary health care utilization.
Original languageEnglish
Pages (from-to)871-878
JournalPsycho-Oncology
Volume27
Issue number3
DOIs
Publication statusPublished - 2018
Externally publishedYes

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