EVALUATION OF THE BURDEN OF DEPRESSION AMONG U.S. VETERAN PATIENTS
Author(s)
Baser O1, Xie L2, Huang A3, Du J2, Wang Y2, Wang L3
1STATinMED Research and The University of Michigan, Ann Arbor, MI, USA, 2STATinMED Research, Ann Arbor, MI, USA, 3STATinMED Research, Plano, TX, USA
OBJECTIVES: To examine the economic burden and health care utilizations of depression patients in the U.S. veteran population. METHODS: Patients diagnosed with depression were identified (International Classification of Disease, 9th Revision, Clinical Modification [ICD-9-CM] diagnosis codes 296.2x, 296.3x, 300.4, 301.13, 309.0x and 311.xx) using the Veterans Health Administration (VHA) Medical SAS datasets from October 1, 2007 through September 30, 2012. The initial diagnosis date was designated as the index date. A comparison cohort was created for patients without a depression diagnosis, using 1:1 propensity score matching to control for age, region, gender, index year and baseline Charlson Comorbidity Index score. For the comparison cohort, the index date was randomly chosen to minimize selection bias. Patients in both cohorts were required to be at least age 18 years, and have continuous medical and pharmacy benefits 1 year pre- and 1 year post-index date. Study outcomes (health care costs, utilizations) were compared between the disease and comparator cohorts, based on the matched sample. RESULTS: After 1:1 matching, a total of 614,093 patients were identified in each group, and baseline characteristics were well-balanced. Patients diagnosed with depression were more likely to have inpatient stays (12.73% vs. 2.09%, p<0.0001) and emergency room (ER) (18.64% vs. 6.24%, p<0.0001), physician office (99.59% vs. 54.08%, p<0.0001), outpatient (99.70% vs. 54.83%, p<0.0001) and pharmacy visits (90.49% vs. 52.20%, p<0.0001). Higher all-cause inpatient stay ($4,017 vs. $599, p<0.0001), ER visit ($199 vs. $55, p<0.0001), physician office visit ($4,034 vs. $1,152, p<0.0001), total outpatient ($4,477 vs. $1,304, p<0.0001), pharmacy ($724 vs. $327, p<0.0001) and total health care costs ($9,218 vs. $2,230, p<0.0001) were also observed for depression patients relative to comparator patients. CONCLUSIONS: During a period of 12 months, VHA patients diagnosed with depression reported higher health care utilization and costs than matched control patients.
Conference/Value in Health Info
2014-05, ISPOR 2014, Palais des Congres de Montreal
Value in Health, Vol. 17, No. 3 (May 2014)
Code
PMH53
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Mental Health