OBJECTIVES

To identify the potential predictors that are associated with increased healthcare expenditures in adult prostate cancer patients with and without depression by applying propensity score matching (PSM).

METHODS

This was a cross-sectional study. Data were obtained from the publicly available Medical Expenditure Panel Survey (MEPS) from 2010 to 2015. We included adult patients with prostate cancer in our study while other types of cancers were excluded. We used 1:1 PSM for cohort formation. Weighted multiple linear regression analysis was conducted to identify potential predictors that are associated with increased of expenditures (dependent variable) in each healthcare services including emergency room visits, hospital inpatient stays, outpatient visits, office-based visits, and prescribed medicines. Demographic variables, socioeconomic factors, insurance types, perceived health status, body mass index, smoking, and Charlson comorbidity index were our independent variables. All costs were adjusted to 2018 U.S dollars.

RESULTS

The weighted total expenditures in prostate cancer patients with depression of emergency room visits, hospital inpatient stays, and outpatient visits were -0.24, 0.65, and 0.24, respectively. These values were statistically significant as well as all the covariates (p <.0001). The weighted total expenditures of office-based visits increased by 0.31 in prostate cancer patients with depression (p = 0.0144). The significant predictors were census region (northeast, p = 0.0002 and south, p = 0.0021), family poverty level (high income, p <.0001), marriage status (married, p = 0.0250), education level (above high school/other degree, p = 0.0048), and perceived health status (fair/poor, p = 0.0037). The weighted total expenditures of prescribed medicines increased by 0.26 in prostate cancer patients with depression, but this rise was not statistically significant (p = 0.2595).

CONCLUSIONS

All predictors studied were associated with an increase of total expenditures in emergency room visits, hospital inpatient stays, and outpatient visits in prostate cancer patients with depression.