Functional status and well-being of patients with chronic conditions: results from the medical outcomes study
Article Abstract:
Most US health care dollars are spent to care for patients with chronic illnesses. The goal is to provide such patients with maximum function in a normal life and to provide the highest level of well-being. Accomplishing these goals may reduce the cost of health care. Little data is available to document the role and impact of chronic illness on life style and general well-being. Measure of function and well-being have been shown to predict health care expenditures and death, although the clinical utility of these measures has not been demonstrated. This study evaluates measures of functioning and well-being in 9,385 adults, who visited to 362 physicians for eight common chronic medical problems. Patients suffering from these conditions had decreased measures of physical, social and mental health, as well as a poorer personal health image and increased pain, than did individuals not suffering from chronic illnesses. Each chronic medical condition had a unique pattern or profile on these measures. As expected, these measures varied significantly among the patients according to the condition. Hypertension (elevated blood pressure) had the least impact on well-being, as opposed to patients with heart problems or gastrointestinal diseases.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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Detection of depressive disorder for patients receiving prepaid or fee-for-service care: results from the medical outcomes study
Article Abstract:
This study examined the awareness of clinicians to detect depression in 650 patients with depressive disorders. Clinicians were from various types of health care settings, including single specialty medical practices with one or more clinicians, large multispecialty group practices, and a health maintenance organization operating in three states. The detection of depression did not differ among the various types of health care settings. Depression was diagnosed in 78 to 87 percent of the patients who visited mental health specialists, but only in 46 to 51 percent of the patients who visited medical clinicians. The type of payment for medical care did not affect whether depression was detected in patients who were examined by mental health specialists. However, among patients visiting medical clinicians, depression was less likely to be diagnosed if care was financed by prepayment systems as compared to fee-for-service programs. The results are consistent with previous findings that mental health care in prepaid plans is less intense than mental health care in fee-for-service programs. These and other findings can contribute to the improvement of health care systems and costs.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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The functioning and well-being of depressed patients: results from the medical outcomes study
Article Abstract:
Data were collected from 11,242 outpatients in three health care facilities in three US cities to determine the functioning and well-being of patients with depression, compared with patients with chronic medical conditions or no chronic conditions. Patients with clinical depression or depressive symptoms, but without disorder, were found to have worse physical, social and role functioning, greater bodily pain and worse perceived health than patients with no chronic conditions. These results were comparable with or worse than those uniquely associated with eight chronic illnesses. Specific examples of poor functioning unique to depression, such as greater numbers of days in bed for these patients, are explored. Chronic medical conditions and depression had unique and additive effects on patient functioning.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
User Contributions:
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