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Am J Geriatr Psychiatry. 2017 Feb;25(2):131-141. doi: 10.1016/j.jagp.2016.10.011. Epub 2016 Nov 2.

The Impact of Depressive Symptoms on Healthcare Costs in Late Life: Longitudinal Findings From the AgeMooDe Study.

Author information

1
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg, Germany. Electronic address: j.bock@uke.de.
2
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg, Germany.
3
Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
4
Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn, Germany.
5
Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
6
Institute of General Practice, Medical Faculty, University of Kiel, Kiel, Germany.
7
Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany.
8
Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.

Abstract

OBJECTIVE:

To examine whether depressive symptoms affect healthcare costs in old age longitudinally.

DESIGN:

Multicenter prospective observational cohort study (two waves with nt1 = 1,195 and nt2 = 951) in Germany.

SETTING:

Community.

PARTICIPANTS:

Participants aged 75 years and older recruited via general practitioners.

MEASUREMENTS:

Depressive symptoms were assessed by the Geriatric Depression Scale (GDS). The health-related resource use was measured retrospectively from a societal perspective based on a questionnaire, covering outpatient services, inpatient treatment, pharmaceuticals, as well as formal and informal nursing care. Hybrid regression models were used to determine the between- and within-effect of depressive symptoms on healthcare costs, adjusting for important covariates.

RESULTS:

Six-month total cost increased from €3,090 (t1) to €3,748 (t2). The hybrid random effects models showed that individuals with more depressive symptoms had higher healthcare costs compared with individuals with less depressive symptoms (between-effect). Moreover, an intra-individual increase in depressive symptoms increased healthcare costs by €539.60 (within-effect) per symptom on GDS.

CONCLUSIONS:

Our findings emphasize the economic importance of depressive symptoms in old age. Appropriate interventions to treat depressive symptoms in old age might also be a promising strategy to reduce healthcare costs.

KEYWORDS:

Depression; depressive symptoms; economic burden; healthcare costs; old age

PMID:
27931772
DOI:
10.1016/j.jagp.2016.10.011
[Indexed for MEDLINE]

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