Cost-Effectiveness Analysis of Collaborative Care Management of Major Depression among Low-Income, Predominantly Hispanics with Diabetes

Mar 1, 2012, 00:00
10.1016/j.jval.2011.09.008
https://www.valueinhealthjournal.com/article/S1098-3015(11)03525-X/fulltext
Title : Cost-Effectiveness Analysis of Collaborative Care Management of Major Depression among Low-Income, Predominantly Hispanics with Diabetes
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(11)03525-X&doi=10.1016/j.jval.2011.09.008
First page : 249
Section Title : Economic Evaluation
Open access? : No
Section Order : 4

Objective

To evaluate the cost-effectiveness of a socioculturally adapted collaborative depression care program among low-income Hispanics with diabetes.

Research design and methods

A randomized controlled trial of 387 patients with diabetes (96.5% Hispanic) with clinically significant depression followed over 18 months evaluated the cost-effectiveness of the Multifaceted Diabetes and Depression Program aimed at increasing patient exposure to evidence-based depression psychotherapy and/or pharmacotherapy in two public safety net clinics. Patient medical care costs and utilization were captured from Los Angeles County Department of Health Services claims records. Patient-reported outcomes included Short-Form Health Survey-12 and Patient Health Questionnaire-9-calculated depression-free days.

Results

Intervention patients had significantly greater Short-Form Health Survey-12 utility improvement from baseline compared with controls over the 18-month evaluation period (4.8%; P 0.001). Medical cost differences were not statistically significant in ordinary least squares and log-transformed cost regressions. The average costs of the Multifaceted Diabetes and Depression Program study intervention were $515 per patient. The program's cost-effectiveness averaged $4053 per quality-adjusted life-year per MDDP recipient and was more than 90% likely to fall below $12,000 per quality-adjusted life-year.

Conclusions

Socioculturally adapted collaborative depression care improved utility and quality of life in predominantly low-income Hispanic patients with diabetes and was highly cost-effective.

Categories :
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Diabetes/Endocrine/Metabolic Disorders
  • Economic Evaluation
  • Mental Health
  • Specific Diseases & Conditions
Tags :
  • cost-utility analysis
  • depression
  • diabetes-related complications
  • direct care health costs
  • randomized clinical trial
Regions :
  • North America
ViH Article Tags :