Manuela Brüne1,2,3, Ute Linnenkamp4,2,3, Silke Andrich4,2,3, Linda Jaffan-Kolb4,2,3, Heiner Claessen2,3, Charalabos-Markos Dintsios4, Imke Schmitz-Losem5, Johannes Kruse6,7, Nadja Chernyak4,2,3, Mickaël Hiligsmann8, Norbert Hermanns9,10, Andrea Icks4,2,3. 1. Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany manuela.bruene@hhu.de. 2. Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. 3. German Center for Diabetes Research (DZD), München-Neuherberg, Germany. 4. Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. 5. pronova BKK, Ludwigshafen, Germany. 6. Department of Psychosomatic and Psychotherapy, University Clinic Gießen, Gießen, Germany. 7. Department of Psychosomatic and Psychotherapy, University Clinic Marburg, Marburg, Germany. 8. Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands. 9. Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany. 10. Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany.
Abstract
OBJECTIVE: Increased health care use and costs have been reported in individuals with diabetes with comorbid depression. Knowledge regarding cost differences between individuals with diabetes alone and those with diabetes and diagnosed/undiagnosed depression is, however, scarce. We therefore compared use and costs for patients with diabetes and no depression and patients with diabetes and documented depression diagnosis or self-reported depression symptoms for several cost components, including mental health care costs. RESEARCH DESIGN AND METHODS: Data from a 2013 cross-sectional survey of randomly sampled members of a nationwide German statutory health insurance (SHI) provider with diabetes (n = 1,634) were linked individually with SHI data covering four quarters before and after the survey. Self-reported depression symptoms were assessed with the Patient Health Questionnaire-9, with depression diagnosis taken from SHI data. We analyzed health care use and costs, using regression analysis to calculate cost ratios (CRs) with adjustment for sociodemographic/socioeconomic factors and comorbidities for two groups: 1) those with no symptoms and no diagnosis and 2) those with symptoms or diagnosis. In our explorative subanalysis we analyzed subgroups with either symptoms or diagnosis separately. RESULTS: Annual mean total health care costs were higher for patients with comorbid depression (EUR 5,629 [95% CI 4,987-6,407]) than without (EUR 3,252 [2,976-3,675], the CR being 1.25 [1.14-1.36]). Regression analysis showed that excess costs were highly associated with comorbidities. Mental health care costs were very low for patients without depression (psychotherapy EUR 2; antidepressants EUR 4) and still relatively low for those with depression (psychotherapy EUR 111; antidepressants EUR 76). CONCLUSIONS: Costs were significantly higher when comorbid depression was present either as symptoms or diagnosed. Excess costs for mental health services were rather low.
OBJECTIVE: Increased health care use and costs have been reported in individuals with diabetes with comorbid depression. Knowledge regarding cost differences between individuals with diabetes alone and those with diabetes and diagnosed/undiagnosed depression is, however, scarce. We therefore compared use and costs for patients with diabetes and no depression and patients with diabetes and documented depression diagnosis or self-reported depression symptoms for several cost components, including mental health care costs. RESEARCH DESIGN AND METHODS: Data from a 2013 cross-sectional survey of randomly sampled members of a nationwide German statutory health insurance (SHI) provider with diabetes (n = 1,634) were linked individually with SHI data covering four quarters before and after the survey. Self-reported depression symptoms were assessed with the Patient Health Questionnaire-9, with depression diagnosis taken from SHI data. We analyzed health care use and costs, using regression analysis to calculate cost ratios (CRs) with adjustment for sociodemographic/socioeconomic factors and comorbidities for two groups: 1) those with no symptoms and no diagnosis and 2) those with symptoms or diagnosis. In our explorative subanalysis we analyzed subgroups with either symptoms or diagnosis separately. RESULTS: Annual mean total health care costs were higher for patients with comorbid depression (EUR 5,629 [95% CI 4,987-6,407]) than without (EUR 3,252 [2,976-3,675], the CR being 1.25 [1.14-1.36]). Regression analysis showed that excess costs were highly associated with comorbidities. Mental health care costs were very low for patients without depression (psychotherapy EUR 2; antidepressants EUR 4) and still relatively low for those with depression (psychotherapy EUR 111; antidepressants EUR 76). CONCLUSIONS: Costs were significantly higher when comorbid depression was present either as symptoms or diagnosed. Excess costs for mental health services were rather low.
Authors: Felipe Saia Tápias; Victor Henrique Oyamada Otani; Daniel Augusto Corrêa Vasques; Thais Zelia Santos Otani; Ricardo Riyoiti Uchida Journal: BMC Health Serv Res Date: 2021-05-06 Impact factor: 2.655
Authors: Emma A Nieuwenhuijse; Jeroen N Struijs; Stephen P Sutch; Mattijs E Numans; Rimke C Vos Journal: Diabet Med Date: 2022-04-01 Impact factor: 4.213