Health care costs associated with @entity308 and XXXX in primary care.

@entity1 @entity308 @entity146 @entity148 @entity74
OBJECTIVE: The authors examined the overall health care costs associated with @entity308 and @entity148 among primary care @entity1 . METHOD: Of 2,110 consecutive primary care @entity1 in a health maintenance organization, 1,962 were screened with the 12-item General Health Questionnaire. A stratified random sample of 615 @entity1 were selected for further diagnostic assessment; 373 of these @entity1 completed the Composite International Diagnostic Interview at baseline and 328 were reassessed 12 months later. Computerized cost records were used to calculate total health care costs for the 6-month period surrounding the baseline assessment and a similar period surrounding the follow-up assessment. Cost accounting data were available for 327 @entity1 at baseline and for 206 @entity1 at both assessments. RESULTS: Primary care @entity1 with DSM-III-R @entity148 or @entity308 at baseline had markedly higher baseline costs ( 2,390) than @entity1 with @entity74 ( 1,098) and those with no @entity148 or @entity308 ( 1,397). Large cost differences persisted after adjustment for medical morbidity. Cost differences reflected higher utilization of general medical services rather than higher mental health treatment costs. Although most @entity1 with baseline @entity148 or @entity308 showed significant improvement, longitudinal analyses did not show any clear relationship between change in @entity146 diagnosis and change in health care cost. CONCLUSIONS: Among primary care @entity1 , @entity148 and @entity308 are associated with markedly higher health care costs even after adjustment for medical comorbidity. In this small sample, improvement in @entity308 over 1 year was not clearly associated with decreases in cost.
