Prevalence of high utilizers of health services with positive history for depression in Primary Health Care

Abstract

Objective: to study the association between history of depression and high use of health services (HUHS) among persons seen in Primary Health Care (PHC), and to establish the prevalence of HUHS, the average number of visits and the epidemiological profile of groups with positive and negative history of depression. Methods: we collected data from family medical records of two Health Units. In order to analyze data regarding the primary outcome and to compare the epidemiological profile of the groups, we used the chi-square test. To compare the difference in mean number of visits between groups, we used the Student’s t-test. Results: we included 278 patients. The prevalence of depression and HUHS in the sample were, respectively, 15.1 and 4.3%. There was a difference in the prevalence of HUHS in the group with positive history of depression, 14.3%, when compared to the group with a negative history of depression, 2.5% (PR = 5.62 , CI 95% 1.90 to 16.59, p = 0.004). The average number of visits in the group with positive history of depression was 5.25 visits / year, while in the group with negative history of depression was 2.59, with a mean difference of 2.65 (CI 95% 1.90 to 3.40; p < 0.001). We also observed higher prevalences of dyspepsia and antidepressant use among HSH. Conclusion: the results support the literature indicating that people with a history of depression tend to make more use of PHC services, with a higher prevalence of HUHS. Thus, a greater knowledge about the profile of the HSH will enable the development of more effective approaches for these users.