title: Depression and risk of hospitalisations and rehospitalisations for ambulatory care-sensitive conditions in Denmark: a population-based cohort study.
abstract: OBJECTIVE
  Hospitalisations for ambulatory care-sensitive conditions (ACSCs), a group of chronic and acute illnesses considered not to require inpatient treatment if timely and appropriate ambulatory care is received, and early rehospitalisations are common and costly. We sought to determine whether individuals with depression are at increased risk of hospitalisations for ACSCs, and rehospitalisation for the same or another ACSC, within 30 days.
  
  
  METHODS
  National, population-based cohort study.
  
  
  METHODS
  Denmark.
  
  
  METHODS
  5,049,353 individuals ≥ 18 years of age between 1 January 2005 and 31 December 2013.
  
  
  METHODS
  Depression was ascertained via psychiatrist diagnoses in the Danish Psychiatric Central Register or antidepressant prescription redemption from the Danish National Prescription Registry. Hospitalisations for ACSCs and rehospitalisations within 30 days were identified using the Danish National Patient Register.
  
  
  RESULTS
  Overall, individuals with depression were 2.35 times more likely to be hospitalised for an ACSC (95% CI 2.32 to 2.37) versus those without depression after adjusting for age, sex and calendar period, and 1.45 times more likely after adjusting for socioeconomic factors, comorbidities and primary care utilisation (95% CI 1.43 to 1.46). After adjusting for ACSC-predisposing comorbidity, depression was associated with significantly greater risk of hospitalisations for all chronic (eg, angina, diabetes complications, congestive heart failure exacerbation) and acute ACSCs (eg, pneumonia) compared to those without depression. Compared to those without depression, persons with depression were 1.21 times more likely to be rehospitalised within 30 days for the same ACSC (95% CI 1.18 to 1.24) and 1.19 times more likely to be rehospitalised within 30 days for a different ACSC (95% CI 1.15 to 1.23).
  
  
  CONCLUSIONS
  Individuals with depression are at increased risk of hospitalisations for ACSCs, and once discharged are at elevated risk of rehospitalisations within 30 days for ACSCs.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA.
authors.forename: Dimitry S
authors.initials: DS
authors.lastname: Davydow
authors.affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Fenger-Grøn
authors.affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Anette Riisgaard
authors.initials: AR
authors.lastname: Ribe
authors.affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Henrik Søndergaard
authors.initials: HS
authors.lastname: Pedersen
authors.affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Prior
authors.affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Unützer
authors.affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Mogens
authors.initials: M
authors.lastname: Vestergaard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003718:Denmark; D003863:Depression / Q000150:complications*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010359:Patient Readmission / Q000706:statistics & numerical data; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: PRIMARY CARE