Impact of Depression on Health Care Utilization and Costs among Multimorbid Patients – Results from the MultiCare Cohort Study

Abstract

ObjectiveThe objective of this study was to describe and analyze the effects of depression on health care utilization and costs in a sample of multimorbid elderly patients.MethodThis cross-sectional analysis used data of a prospective cohort study, consisting of 1,050 randomly selected multimorbid primary care patients aged 65 to 85 years. Depression was defined as a score of six points or more on the Geriatric Depression Scale (GDS-15). Subjects passed a geriatric assessment, including a questionnaire for health care utilization. The impact of depression on health care costs was analyzed using multiple linear regression models. A societal perspective was adopted.ResultsPrevalence of depression was 10.7%. Mean total costs per six-month period were €8,144 (95% CI: €6,199-€10,090) in patients with depression as compared to €3,137 (95% CI: €2,735-€3,538; p<0.001) in patients without depression. The positive association between depression and total costs persisted after controlling for socio-economic variables, functional status and level of multimorbidity. In particular, multiple regression analyses showed a significant positive association between depression and pharmaceutical costs.ConclusionAmong multimorbid elderly patients, depression was associated with significantly higher health care utilization and costs. The effect of depression on costs was even greater than reported by previous studies conducted in less morbid patients.

Depressive Symptoms in Recipients of Home- and Community-Based Services in the United States: Are Older Adults Receiving the Care They Need?

“…Even accounting for these factors, significant depressive symptoms were associated with use of HCBS. This finding is consistent with findings that show that depressive symptoms are associated with increased health service use and costs (37–39). Depressive symptoms may be an indicator of unmeasured physical health severity or other mental health needs of the population.…”

Risk Factors for Depression in Elderly Persons Attending the General Outpatient Clinics of the University of Uyo Teaching Hospital, Uyo

“…Besides personal and family suffering, depression in later life leads to an array of medical, psychosocial, and economic consequences including increased morbidity and mortality, increased disability, 5 decreased quality of life, 6 and an increase in both health care costs and health service utilization. 7 Furthermore, depression characteristically complicates the course and outcome of other illnesses among older adults. 8 The risk factors for depression in the elderly are not so different from those with the young population; however, the impact of these risk factors varies with age and gender.…”

Factors Associated with Costs of Hospitalization of Severely Mentally Ill Patients

“…Excluding dementias, they occur at a combined lifetime prevalence of nearly 5% for psychotic and bipolar disorders and approximately 10% for major depressive disorder [1][2][3]. As largely chronic or recurrent illnesses, they carry high risks of disability and early mortality, in addition to representing extraordinary direct (care) and indirect (disability) costs to society [4][5][6][7][8][9][10][11]. Such disorders particularly during acute dysfunction, dangerousness, and with commonly co-occurring general medical illness represent the most frequent reason for hospitalization in psychiatric units of general hospitals as well as specialized institutions [2,3,[12][13][14].…”

“…Such efforts aim to improve allocation of services that address such risk factors, as well as predicting and managing costs associated with illnesses that require more intensive treatment [3,11,40,[43][44][45]. Proposed risk factors for psychiatric hospitalization include repeated occurrences or exacerbations of illness, greater overall illness severity, disability and poverty, as well as suspected non-adherence to recommended treatment [46][47][48][49][50][51][52][53].…”