우울증의 한의표준임상경로 개발 및 시범 적용 연구
A Study on the Development and Application of Korean Medical Critical Pathway of Depression
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Objectives: To examine treatment outcomes and cost of the Korean Medical Critical Pathway (CP) in the treatment of depression. Methods: This was a retrospective study. A total of 60 patients who fulfilled all the information relevant to this study were included after reviewing the electronic medical record (EMR). Among them, 30 patients who met at least 70% of the CP were assigned to the CP group and 30 patients who did not meet the CP were assigned to the non-CP group. A comparison was made between the two groups regarding their demographic characteristics, clinical characteristics, economic indices, and satisfaction with care. Clinical indices of the two groups before and after treatment were also compared. Results: The CP group exhibited notable reductions in the treatment period, number of hospital visits, cost of treatment, and subsequent visit fees when compared to the non-CP group. However, changes in questionnaire scores that indicated clinical improvement and satisfaction of care were not statistically significant between the two groups. Conclusions: This study demonstrated the efficacy of CP in the treatment of depression, particularly in terms of reducing treatment duration, hospital visits, and associated costs. While clinical outcomes were comparable between the two groups, the CP approach demonstrated advantages in reducing healthcare utilization and costs for depression management. This could lead to enhanced patient outcomes and reduced healthcare costs at the national level.
Abstract
Objectives: To examine treatment outcomes and cost of the Korean Medical Critical Pathway (CP) in the treatment of depression. Methods: This was a retrospective study. A total of 60 patients who fulfilled all the information relevant to this study were included after reviewing the electronic medical record (EMR). Among them, 30 patients who met at least 70% of the CP were assigned to the CP group and 30 patients who did not meet the CP were assigned to the non-CP group. A comparison was made between the two groups regarding their demographic characteristics, clinical characteristics, economic indices, and satisfaction with care. Clinical indices of the two groups before and after treatment were also compared. Results: The CP group exhibited notable reductions in the treatment period, number of hospital visits, cost of treatment, and subsequent visit fees when compared to the non-CP group. However, changes in questionnaire scores that indicated clinical improvement and satisfaction of care were not statistically significant between the two groups. Conclusions: This study demonstrated the efficacy of CP in the treatment of depression, particularly in terms of reducing treatment duration, hospital visits, and associated costs. While clinical outcomes were comparable between the two groups, the CP approach demonstrated advantages in reducing healthcare utilization and costs for depression management. This could lead to enhanced patient outcomes and reduced healthcare costs at the national level.
참고문헌 (28)
- Kessler RC, "The Epidemiology of Major Depressive DisorderResults From the National Comorbidity Survey Replication(NCS-R)", JAMA, 289(23), pp.3095~3105 (2003)[DOI]
- Cui L, "Major depressive disorder : hypothesis, mechanism, prevention and treatment", Signal Transduction and Targeted Therapy, 9(1), pp.30~ (2024)[DOI]
- "A review of the care provided for patients with depression and anxiety disorders over the past five years (2017-2021)" (2022)[URL]
- Health Plan 2030: the 5th National Health Plan (‘21∼’30), "Ministry of Health and Welfare", Korea Health Promotion Institute, ~ (2022)
- Ge L, "Research progress on methodology of clinical practice guideline in the traditional Chinese medicine", Integrative Chinese medicine Field, 2022, pp.39(4), 279~284
- EBM-based Depression Korean Medicine Clinical Guidelines Development Commitee, "Depression Korean Medicine Clinical Guidelines", Institute of Oriental Medicine: Korean Neuropsychiatric Association, ~ (2015)
- Kinsman L, "What is a Critical Pathway? Development of a definition to inform the debate", BMC medicine, 8, pp.1~3 (2010)[DOI]
- Milroy S, "Associations between Critical Pathway concordance, cost, and survival outcomes for stage II colon cancer : a population-based study", International Journal for Quality in Health Care, 35(2), pp.mzad012~ (2023)[DOI]
- Murray AL, "Critical Pathway effectiveness : febrile young infant Critical Pathway in a pediatric emergency department", Pediatric emergency care, 33(9), pp.e33~ (2017)[DOI]
- Dohyung K, "Developing a Clinical Pathway of Korean Medicine for Managing Patients with Depression", Journal of Oriental Neuropsychiatry, 34(1), pp.1~12 (2023)[DOI]
- Hamilton M, "A rating scale for depression", Journal of neurology, neurosurgery, and psychiatry, 23(1), pp.56~ (1960)[DOI]
- Beck AT, "Comparison of Beck Depression Inventories-IA and-II in psychiatric outpatients", Journal of personality assessment, 67(3), pp.588~597 (1996)[DOI]
- Lim SY, "The Validation Study of Beck Depression Scale 2 in Korean Version", Journal of the Korean Society of Anxiety, 7(1), pp.48~53 (2011)
- Spielberger CD, "Anxiety: Current Trends in Theory and Research", pp.23~49 (1972), Acedemic Press
- Spielberger CD, "Assessment of emotions : Anxiety, anger, depression, and curiosity", Applied Psychology : Health and Well-Being, 1(3), pp.271~302 (2009)[DOI]
- Dae-Myung P, "The Correlation of Psychological Scale Measurements in Depression, Anxiety and Insomnia Patients and its Value", Journal of Oriental Neuropsychiatry, 23(3), pp.63~75 (2012)[DOI]
- Spielberger C, "Manual for the State Trait Anger Expression Inventory(STAXI)" (1988), Psychological Assessment Resources Inc
- "EuroQol--a new facility for the measurement of health-related quality of life", Health Policy, 16(3), pp.199~208 (1990)[DOI]
- Rush AJ, "Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression", N Engl J Med, 354(12), pp.1231~1242 (2006)[DOI]
- Mathew BK, "Which aspect of patient–provider relationship affects acceptance and adherence of insulin therapy in type 2 diabetes mellitus? A qualitative study in primary care", Diabetes, Metabolic Syndrome and Obesity, 15, pp.235~246 (2022)[DOI]
- Shay LA, "Where is the evidence? A systematic review of shared decision making and patient outcomes", Med Decis Making, 35, pp.114~131 (2014)[DOI]
- Drake RE, "Shared decision making in mental health : prospects for personalized medicine", Patient Educ Couns, 11(4), pp.455~463 (2022)[DOI]
- Katon W, "Collaborative depression care : history, evolution, and ways to enhance dissemination and sustainability", Gen Hosp Psychiatry, 32(5), pp.456~464 (2010)[DOI]
- Simon GE, "Cost-effectiveness of systematic depression treatment for high utilizers of general medical care", Arch Gen Psychiatry, 58(2), pp.181~187 (2001)[DOI]
- Rush AJ, "Clinical research challenges posed by difficult-to-treat depression", Psychological Medicine, 52(3), pp.419~432 (2022)[DOI]
- DeLaroche AM, "Pediatric stroke Critical Pathway improves the time to diagnosis in an emergency department", Pediatric Neurology, 65, pp.39~44 (2016)[DOI]
- de Belvis AG, "Ischemic stroke : Critical Pathway impact", International journal of health care quality assurance, 32(3), pp.588~598 (2019)[DOI]
- Norra C, "A new electronically based Critical Pathway for schizophrenia inpatients : a longitudinal pilot study", Schizophrenia Research, 238, pp.82~90 (2021)[DOI]
