Depression is among the most common mental illnesses, and it comes with a set of challenges that affects many different aspects of the patient’s life. New research suggests that depression is not only difficult to manage on its own, but those suffering from the condition are more than twice as likely to have hospitalizations that could be preventable. Patients with depression were also more likely to return to the hospital within 30 days for the same problem, according to the study.

Preventable hospitalizations are known as hospitalizations for ambulatory care-sensitive conditions, and include the exacerbation of common chronic conditions like congestive heart failure, diabetes, and chronic obstructive pulmonary disease. It can also include acute illnesses, such as urinary tract infections and bacterial pneumonia. These hospitalizations are estimated to cost the U.S. Centers for Medicare and Medicaid Services $32 billion a year. Apart from costliness, adverse health effects of hospitalization can contribute to cognitive and functional decline in older patients, leading researchers to attempt and understand who may be at greatest risk for preventable hospitalization.

The team, led by Dr. Dimitry S. Davydow, University of Washington associate professor of psychiatry and behavioral sciences, sought to determine the role of depression in these hospitalizations. To investigate, they analyzed data collected on five million Danish adults to see if individuals with depression were more likely to be hospitalized for preventable conditions, or if they were more likely to be readmitted within 30 days of discharge.

The researchers found that out of the five million citizens studied, more than 1.3 million 926.1 percent had been diagnosed with depression, or had been prescribed antidepressant medication during the eight-year study. In all, those with depression were 2.35 times more likely to be hospitalized for a preventable condition, even after the team controlled for age, sex, and passage of time.

They even accounted for socioeconomic factors, the presence of other diseases, and frequency of primary care. After all of this, those diagnosed with depression were still 1.45 times more likely to have a preventable hospitalization. They were also 1.21 times more likely to be re-hospitalized for the same condition within 30 days of discharge, and 1.19 times more likely to be readmitted with a different one.

Lack of access to primary care is a poor explanation for the hospitalizations, since Denmark provides all of its citizens with universal primary care access and health insurance.

“Providing better access to primary care may not be enough,” Davydow said in a press release. “One solution may be to do a better job integrating mental health services into primary care settings. That way patients with depression can obtain psychiatric care more easily and their mental health care better incorporated into their overall health care.”

Davydow explained that several studies have shown this type of collaborative care can be medically and cost effective. He said more research would be necessary to show if these integrated approaches are capable of reducing preventable hospitalizations in those with depression or other mental health conditions.

Source: Davydow D. BMJ Open. 2015.