title: Quality of life and use of health care resources among patients with chronic depression.
abstract: OBJECTIVE
  This study estimates the health-related quality of life and the health care resource utilization of patients diagnosed with chronic depression (CD) in Spain.
  
  
  METHODS
  We used the Spanish National Health Survey 2011-2012, a cross-sectional survey representative at the national level, that selects people aged between 18 and 64 years (n=14,691). We estimated utility indices through the EuroQol five-dimensional descriptive system questionnaire included in the survey. We calculated percentage use of health care resources (medical visits, hospitalizations, emergency services, and drug consumption) and average number of resources used when available. A systematic comparison was made between people diagnosed with CD and other chronic conditions (OCCs). The chi-square test, Mann-WhitneyU-test, and Kruskal-Wallis test were used to determine the statistical significance of differences between comparison groups. Multivariate analyses (Poisson regression, logistic regression, and linear regression) were also carried out to assess the relationship between quality of life and consumption of health care resources.
  
  
  RESULTS
  Approximately, 6.1% of the subjects aged between 18 and 64 years were diagnosed with CD (average age 48.3±11 years, 71.7% females). After controlling for age, sex, and total number of comorbidities, a diagnosis of CD reduced utility scores by 0.09 (P<0.05) vs OCCs, and increased the average number of hospitalizations by 15%, the average number of days at hospital by 51%, and the average number of visits to emergency services by 15% (P<0.05). CD also increased the average number of visits to secondary care by 14% and visits to general practitioners by 4%. People with CD had a higher probability of consuming drugs than people with OCCs (odds ratio [OR]: 1.24,P<0.05), but only 38.6% took antidepressants.
  
  
  CONCLUSIONS
  People with CD had significantly lower health-related quality of life than people with OCCs. CD was associated with increased hospital length of stay and involved a higher consumption of emergency services and drugs than OCCs.
authors.affiliation: Department of Health Economics, Instituto Max Weber, Madrid.
authors.forename: Renata
authors.initials: R
authors.lastname: Villoro
authors.affiliation: Department of Health Economics, Instituto Max Weber, Madrid.
authors.forename: María
authors.initials: M
authors.lastname: Merino
authors.affiliation: Department of Economics and Finance, University of Castilla-La Mancha, Toledo, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Hidalgo-Vega
keywords: Spain; burden of disease; depression; health care resources; utility