Open AccessLongitudinal Investigation of Depression Outcomes (the LIDO study) in primary care in six countries: comparative assessment of local health systems and resource utilization
Author(s) -
Chisholm Daniel,
Amir Marianne,
Fleck Marcelo,
Herrman Helen,
Lomachenkov Aleksandr,
Lucas Ramona,
Patrick Donald
Publication year - 2001
Publication title -
international journal of methods in psychiatric research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.275
H-Index - 73
eISSN - 1557-0657
pISSN - 1049-8931
DOI - 10.1002/mpr.101
Subject(s) - receipt , observational study , medicine , service (business) , depression (economics) , service delivery framework , quality of life (healthcare) , cohort study , gerontology , environmental health , business , nursing , marketing , accounting , pathology , economics , macroeconomics
In spite of the high societal burden imposed by major depression globally, there is only limited understanding of the economic consequences of the condition in different cultural settings. Objectives: to describe the research methods employed in a multinational longitudinal investigation of resource utilization and quality of life among depressed primary care patients, and to compare the sites, service systems and populations in the LIDO study. Method: a six‐site, cross‐national observational study design was used to assess associations between quality of life, economic and depression outcomes in a prospective cohort of primary care patients with recognized major depressive disorder. A sociodemographic and service profile of each participating site was developed, enabling quantitative (as well as qualitative) comparisons of service delivery and study populations. In addition to measurement of depression symptoms and quality of life, resource utilization of enrolled subjects was assessed via an interviewer‐led questionnaire containing internationally comparable items of potential service receipt. A set of unit costs for all itemized services was generated, based on a common protocol and standardized methodology. Results: comparison of sociodemographic and service indicators usefully revealed the considerable variability between sites in terms of overall expenditure or service inputs and the underlying model of health care finance and provision. There were also discernible differences in the baseline sociodemography and service utilization patterns of the six sampled populations, a number of which could be related to identified site‐level characteristics. Conclusion: multinational investigations of health service utilization and costs are complicated by the heterogeneity of service systems and the need to reflect the contexts within which people live and receive their care. In order to be locally meaningful yet internationally comparable, a carefully constructed approach towards data collection, analysis and interpretation is required. Copyright © 2001 Whurr Publishers Ltd.