Depression predicts future emergency hospital admissions in primary care patients with chronic physical illness

Abstract

Objective More than 15 million people currently suffer from a chronic physical illness in England. The objective of this study was to determine whether depression is independently associated with prospective emergency hospital admission in patients with chronic physical illness. Method 1860 primary care patients in socially deprived areas of Manchester with at least one of four exemplar chronic physical conditions completed a questionnaire about physical and mental health, including a measure of depression. Emergency hospital admissions were recorded using GP records for the year before and the year following completion of the questionnaire. Results The number of patients who had at least one emergency admission in the year before and the year after completion of the questionnaire were 221/1411 (15.7%) and 234/1398 (16.7%) respectively. The following factors were independently associated with an increased risk of prospective emergency admission to hospital; having no partner OR 1.49 (95% CI 1.04 to 2.15); having ischaemic heart disease OR 1.60 (95% CI 1.04 to 2.46); having a threatening experience OR 1.16 (95% CI 1.04 to 1.29) per experience; depression OR 1.58 (95% CI 1.04 to 2.40); emergency hospital admission in year prior to questionnaire completion OR 3.41 (95% CI (1.98 to 5.86). Conclusion To prevent potentially avoidable emergency hospital admissions, greater efforts should be made to detect and treat co-morbid depression in people with chronic physical illness in primary care, with a particular focus on patients who have no partner, have experienced threatening life events, and who have had a recent emergency hospital admission.