Rebecca L Robinson1, Michael Grabner2, Swetha Rao Palli3, Douglas Faries4, Judith J Stephenson2. 1. Eli Lilly and Company, Indianapolis, IN, United States. Electronic address: rlrobinson@lilly.com. 2. HealthCore, Inc., Wilmington, DE, United States. 3. CTI Clinical Trial and Consulting Services, Cincinnati, OH, United States. 4. Eli Lilly and Company, Indianapolis, IN, United States.
Abstract
OBJECTIVE: To characterize healthcare costs, resource use, and treatment patterns of survey respondents with a history of depression who are high utilizers (HUds) of healthcare and to identify factors associated with high utilization. METHODS: Adults with two or more depression diagnoses identified from the HealthCore Integrated Research Database were invited to participate in the CODE study, which links survey data with 12-month retrospective claims data. Patient surveys provided data on demographics, general health, and symptoms and/or comorbidities associated with depression. Similar clinical conditions also were identified from the medical claims. Factors associated with high utilization were identified using logistic regression models. RESULTS: Of 3132 survey respondents, 1921 were included, 193 of whom were HUds (defined as those who incurred the top 10% of total all-cause costs in the preceding 12months). Mean total annual healthcare costs were eightfold greater for HUds than for non-HUds ($US56,145 vs. $US6,954; p<.0001). HUds incurred more inpatient encounters (p<.0001) and emergency department (p=.01) and physician office visits (p<.0001). Similar findings were observed for mental healthcare costs/resource use. HUds were prescribed twice as many medications (total mean: 16.86 vs. 8.32; psychotropic mean: 4.11 vs. 2.61; both p<.0001). HUds reported higher levels of depression severity, fatigue, sleep difficulties, pain, high alcohol consumption, and anxiety. Predictors of becoming a HUd included substance use, obesity, cardiovascular disease, comorbidity severity, psychiatric conditions other than depression, and pain. CONCLUSION: Focusing on pain, substance use, and psychiatric conditions beyond depression may be effective approaches to reducing high costs in patients with depression.
OBJECTIVE: To characterize healthcare costs, resource use, and treatment patterns of survey respondents with a history of depression who are high utilizers (HUds) of healthcare and to identify factors associated with high utilization. METHODS: Adults with two or more depression diagnoses identified from the HealthCore Integrated Research Database were invited to participate in the CODE study, which links survey data with 12-month retrospective claims data. Patient surveys provided data on demographics, general health, and symptoms and/or comorbidities associated with depression. Similar clinical conditions also were identified from the medical claims. Factors associated with high utilization were identified using logistic regression models. RESULTS: Of 3132 survey respondents, 1921 were included, 193 of whom were HUds (defined as those who incurred the top 10% of total all-cause costs in the preceding 12months). Mean total annual healthcare costs were eightfold greater for HUds than for non-HUds ($US56,145 vs. $US6,954; p<.0001). HUds incurred more inpatient encounters (p<.0001) and emergency department (p=.01) and physician office visits (p<.0001). Similar findings were observed for mental healthcare costs/resource use. HUds were prescribed twice as many medications (total mean: 16.86 vs. 8.32; psychotropic mean: 4.11 vs. 2.61; both p<.0001). HUds reported higher levels of depression severity, fatigue, sleep difficulties, pain, high alcohol consumption, and anxiety. Predictors of becoming a HUd included substance use, obesity, cardiovascular disease, comorbidity severity, psychiatric conditions other than depression, and pain. CONCLUSION: Focusing on pain, substance use, and psychiatric conditions beyond depression may be effective approaches to reducing high costs in patients with depression.
Authors: Aaron Samuel Breslow; Nathaniel M Tran; Frederick Q Lu; Jonathan E Alpert; Benjamin Lê Cook Journal: Curr Psychiatry Rep Date: 2019-09-21 Impact factor: 5.285
Authors: Zoe M Weinstein; Debbie M Cheng; Maria J D'Amico; Leah S Forman; Danny Regan; Alexandra Yurkovic; Jeffrey H Samet; Alexander Y Walley Journal: Drug Alcohol Depend Date: 2020-05-25 Impact factor: 4.492
Authors: Elżbieta W Buczak-Stec; Margrit Löbner; Janine Stein; Anne Stark; Hanna Kaduszkiewicz; Jochen Werle; Kathrin Heser; Birgitt Wiese; Siegfried Weyerer; Michael Wagner; Martin Scherer; Steffi G Riedel-Heller; Hans-Helmut König; André Hajek Journal: Front Med (Lausanne) Date: 2022-07-22