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PLoS One. 2014 Mar 17;9(3):e91973. doi: 10.1371/journal.pone.0091973. eCollection 2014.

Impact of depression on health care utilization and costs among multimorbid patients--from the MultiCare Cohort Study.

Author information

1
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
2
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
3
Department of Psychiatry, Technical University of Munich, Munich, Germany.
4
Department of General Practice, University of Düsseldorf Medical Center, Düsseldorf, Germany.
5
Department of General Practice, Jena University Hospital, Jena, Germany.
6
Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
7
Institute of General Practice, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany.
8
Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
9
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
10
Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
11
Institute for Biometry, Hannover Medical School, Hannover, Germany.

Abstract

OBJECTIVE:

The 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.

METHOD:

This 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.

RESULTS:

Prevalence 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.

CONCLUSION:

Among 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.

PMID:
24638040
PMCID:
PMC3956806
DOI:
10.1371/journal.pone.0091973
[Indexed for MEDLINE]
Free PMC Article
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