Association of Mental Health Disorders With Health Care Utilization and Costs Among Adults With Chronic Disease

Abstract

Key Points Question Are mental health disorders associated with health care utilization and costs among people with chronic diseases? Findings In this population-based cohort study of 991 445 Canadian adults, including 156 296 with a mental health disorder, 3-year adjusted mean costs were $38 250 for those with a mental health disorder and $22 280 for those without a mental health disorder. Presence of a mental health disorder was associated with higher rates of hospitalization and emergency department visits, including when considering only visits associated with chronic disease and ambulatory care–sensitive conditions. Meaning In this study, mental health disorders were associated with substantially higher resource utilization and health care costs in patients with chronic diseases.

Severe mental illness and health service utilisation for nonpsychiatric medical disorders: A systematic review and meta-analysis

“…Table 2 describes the 30 studies (containing 38 separate analyses) that assessed the impact of SMI on nonpsychiatric LOS [ 17 , 18 , 20 , 28 – 30 , 32 , 40 – 42 , 46 – 65 ]. In 29 of the 38 analyses, SMI was associated with increased LOS.…”

“…Fifteen studies (17 analyses) were potentially suitable for meta-analysis, as they reported the mean LOS (and standard deviation or CIs) for patients with and without SMI [ 20 , 28 , 30 , 41 , 42 , 46 , 48 , 51 , 54 , 56 , 58 , 59 , 61 , 62 , 65 ]. The Higgins’ I 2 indicated that the set of studies were extremely heterogeneous (χ 2 [ 16 ] = 15,432.12, p < 0.001, I 2 = 100%); therefore, the estimation of the overall pooled effect should be interpreted with caution.…”

“…Two means were entered into the meta-analysis from Falsgraf and colleagues (2017) [ 54 ], as data were presented for patients with bipolar disorder and schizophrenia separately. Two means were entered for Sporinova and colleagues (2019) [ 42 ] as length of stay was looked at separately in patients hospitalised for chronic physical conditions and patients hospitalised for ACSCs. ACSC, ambulatory care sensitive condition; CI, confidence interval; SD, standard deviation; SMI, severe mental illness; Std., standard.…”

“…Table 4 describes the 15 studies (20 analyses) included in the review that assessed the impact of SMI on the use of emergency care [ 20 , 23 , 29 , 31 , 32 , 34 , 39 , 42 , 44 , 45 , 70 , 76 , 84 – 86 ]. In 18 out of 20 of the analyses, SMI was associated with increased use of emergency departments.…”

Pre-Existing and New-Onset Depression and Anxiety Among Workers With Injury or Illness Work Leaves

“… 43 However, our study population likely had some sort of mental health coverage, since 98% of individuals with an employer sponsored health plan had mental health coverage in 2009, prior to the Affordable Care Act which expanded behavioral health parity. 44 Our regression models could not properly control for overall healthcare service utilization, which is correlated with the presence of mental health disorders, 45 as healthcare utilization is a mediator between exposure and outcome in our study and could bias the results. Finally, our study population had some differing demographic characteristics than BLS data on private workers and IBI's benchmarking database, which indicates that future research is needed to confirm that the results presented in this study are generalizable to a population with different sociodemographic characteristics.…”