title: Healthcare utilization patterns before and after contact with psychiatrist care for panic disorder.
abstract: BACKGROUND
  This study aimed to examine healthcare utilization and expenditures in the six months before and after a patient contacted with psychiatrist care for panic disorder (PD), using a nationwide population-based database in Taiwan.
  
  
  METHODS
  We used data from Taiwan's National Health Insurance Research Database covering the years 2002 to 2005. Our study sample included 15,374 patients with PD. We compare changes in the number of ER and outpatient visits and associated six months before and after a patient received psychiatric treatment for PD, by performing paired t-tests.
  
  
  RESULTS
  Results indicate that despite increased mean numbers and costs for total and psychiatric outpatient visits after patients contacted with psychiatrist care for PD, there was a significantly lower number of emergency visits (0.86 vs. 0.62, p<0.001) and non-psychiatric outpatient visits (16.1 vs. 15.6, p<0.001) after psychiatric treatment, saving NT$452.8 and NT$312.9 dollars, respectively. Furthermore, we found that the mean monthly ER use and costs demonstrated a steadily upward trend peaking in the month prior to contacting with psychiatrist care for PD, followed by a sharp decrease in the month after.
  
  
  CONCLUSIONS
  We identified patients diagnosed with PD by ICD-9-CM codes from administrative claims data, the validity of diagnoses could be compromised.
  
  
  CONCLUSIONS
  The treatment of PD might cause an increase in healthcare expenditures for psychiatric visits; nevertheless, it would also reduce utilization of medical resources for symptoms associated with PD. Our study highlights the need to target PD for early identification and treatment.
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan. yichen@tmu.edu.tw
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Chen
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Chen
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.forename: Hsin-Chien
authors.initials: HC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D004632:Emergency Medical Services / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000628:therapy*; D011570:Psychiatry; D013624:Taiwan; D013997:Time Factors