TY - JOUR
KW - Adult
KW - Antidepressive Agents/economics/therapeutic use
KW - Comorbidity
KW - Depressive Disorder/economics/therapy
KW - Female
KW - Health Care Costs
KW - Health Maintenance Organizations/economics
KW - Health Services/utilization
KW - Humans
KW - Male
KW - Primary Health Care/economics/utilization
KW - Records as Topic
AU - G. E. Simon
AU - M. Von Korff
AU - W. Barlow
A1 - 
AB - BACKGROUND: While an extensive literature documents the influence of depression on general medical services utilization, estimates of the economic burden of depression have focused on the direct costs of depression treatment. Higher use of general medical services may contribute significantly to the true cost of depressive illness. METHODS: Computerized record systems of a large staff-model health maintenance organization (HMO) were used to identify consecutive primary care patients with visit diagnoses of depression (n = 6257) and a comparison sample of primary care patients with no depression diagnosis (n = 6257). The HMO accounting records were used to compare components of health care costs. RESULTS: Patients diagnosed as depressed had higher annual health care costs ($4246 vs $2371, P < .001) and higher costs for every category of care (eg, primary care, medical specialty, medical inpatient, pharmacy, laboratory). Similar cost differences were observed for each of the subgroups examined (patients treated with antidepressants, those not treated with antidepressants, and those diagnosed at routine physical examination visits). Pharmacy records indicated greater chronic medical illness in the diagnosed depression group, but large cost differences remained after adjustment ($3971 vs $2644). Twofold cost differences persisted for at least 12 months after initiation of treatment. CONCLUSIONS: Diagnosis of depression is associated with a generalized increase in use of health services that is only partially explained by comorbid medical conditions. In the primary care sector, this greater medical utilization exceeds direct treatment costs for depression. The persistence of utilization differences suggests that recognition and initiation of treatment alone are not adequate to reduce utilization differences.
BT - Archives of General Psychiatry
C5 - Financing & Sustainability
CP - 10
CY - UNITED STATES
IS - 10
JF - Archives of General Psychiatry
N2 - BACKGROUND: While an extensive literature documents the influence of depression on general medical services utilization, estimates of the economic burden of depression have focused on the direct costs of depression treatment. Higher use of general medical services may contribute significantly to the true cost of depressive illness. METHODS: Computerized record systems of a large staff-model health maintenance organization (HMO) were used to identify consecutive primary care patients with visit diagnoses of depression (n = 6257) and a comparison sample of primary care patients with no depression diagnosis (n = 6257). The HMO accounting records were used to compare components of health care costs. RESULTS: Patients diagnosed as depressed had higher annual health care costs ($4246 vs $2371, P < .001) and higher costs for every category of care (eg, primary care, medical specialty, medical inpatient, pharmacy, laboratory). Similar cost differences were observed for each of the subgroups examined (patients treated with antidepressants, those not treated with antidepressants, and those diagnosed at routine physical examination visits). Pharmacy records indicated greater chronic medical illness in the diagnosed depression group, but large cost differences remained after adjustment ($3971 vs $2644). Twofold cost differences persisted for at least 12 months after initiation of treatment. CONCLUSIONS: Diagnosis of depression is associated with a generalized increase in use of health services that is only partially explained by comorbid medical conditions. In the primary care sector, this greater medical utilization exceeds direct treatment costs for depression. The persistence of utilization differences suggests that recognition and initiation of treatment alone are not adequate to reduce utilization differences.
PP - UNITED STATES
PY - 1995
SN - 0003-990X; 0003-990X
SP - 850
EP - 856
EP - 
T1 - Health care costs of primary care patients with recognized depression
T2 - Archives of General Psychiatry
TI - Health care costs of primary care patients with recognized depression
U1 - Financing & Sustainability
U2 - 7575105
VL - 52
VO - 0003-990X; 0003-990X
Y1 - 1995
ER -