Mood Emot 2023 Nov; 21(3): 95-103   https://doi.org/10.35986/me.2023.21.3.95
Quality of Early Depression Management and Long-Term Medical Use: Aspect of Quality Indicators for Outpatients with Depression
Hyun Ho Lim, MD1,2 , Jae Kwang Lee, MHA3 , Sunyoung Park, MD2,4 , Jhin Goo Chang, MD, PhD5 , Jooyoung Oh, MD, PhD2,6 , Jaesub Park, MD2,4 , Jungeun Song, MD2,4
1Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, 2Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, 3Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, 4Department of Psychiatry, National Health Insurance Service Ilsan Hospital, 5Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, 6Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Jaesub Park, MD
Department of Psychiatry, National Health Insurance Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea
TEL +82-31-900-3235 FAX +82-31-900-0049 E-mail psy.ilsan@nhimc.or.kr ORCID https://orcid.org/0000-0003-2597-2204
Jungeun Song, MD
Department of Psychiatry, National Health Insurance Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea
TEL +82-31-900-3235 FAX +82-31-900-0049 E-mail jesong@nhimc.or.kr ORCID https://orcid.org/0000-0003-0697-9320
Received: July 29, 2023; Accepted: August 21, 2023; Published online: November 30, 2023.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Depression is a global mental health concern that negatively affects individuals’ health and increases medical costs. This study aimed to assess whether early depression management is cost-beneficial and effective from the perspective of quality indicators.
Methods: Data of patients newly diagnosed with depressive disorder between 2012 and 2014 as well as follow-up data until 2020 were extracted from the National Health Insurance Service database. Hospitalization, emergency room visits, and annual medical expenses were set as dependent variables to estimate the effect of depression and information on medical expenditures. Six quality indicators developed by the Health Insurance Review and Assessment Service comprised independent variables.
Results: In total, 465,766 patients were included in this study. Patients who met the quality indicators were more likely to be hospitalized with a psychiatric diagnosis. Furthermore, patients who met the quality indicator of revisiting within 3 weeks of their first visit had greater psychiatric and overall expenses during the early treatment phase; however, the overall expenses gradually decreased over time.
Conclusion: High-quality initial treatment for depression can be cost-effective in the long term; however, further studies are needed to discern its immediate clinical effects.
Keywords: Depression; Quality indicators, health care; Cost benefit analysis; Mental health

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