TY - JOUR
KW - Adolescent
KW - Adult
KW - Bipolar Disorder/diagnosis/economics/epidemiology
KW - Cost Savings/statistics & numerical data
KW - Decision Support Techniques
KW - Depressive Disorder, Major/diagnosis/economics/epidemiology
KW - Diagnostic Errors
KW - Early Diagnosis
KW - Female
KW - Health Care Costs
KW - Humans
KW - Male
KW - Managed Care Programs/economics
KW - Mass Screening/economics/methods
KW - Models, Economic
KW - Monte Carlo Method
KW - Primary Health Care/economics/methods/statistics & numerical data
KW - Questionnaires
AU - J. Menzin
AU - M. Sussman
AU - E. Tafesse
AU - C. Duczakowski
AU - P. Neumann
AU - M. Friedman
A1 - 
AB - OBJECTIVE: Unrecognized bipolar disorder in patients presenting with a major depressive episode may lead to delayed diagnosis, inappropriate treatment, and excessive costs. This study models the cost effectiveness of screening for bipolar disorder among adults presenting for the first time with symptoms of major depressive disorder. METHOD: A decision-analysis model was used to evaluate the outcomes and cost over 5 years of screening versus not screening for bipolar disorder. Screening was defined as a 1-time administration of the Mood Disorder Questionnaire at the initial visit followed by referral to a psychiatrist for patients screening positive for bipolar disorder. Health states included correctly diagnosed bipolar disorder, unrecognized bipolar disorder, and correctly diagnosed major depressive episodes. Model outcomes included rates of correct diagnosis of bipolar disorder and discounted costs (2006 US dollars) of screening and treating major depressive episodes. Literature was the primary source of data and was collected from September 2007 through March 2009. RESULTS: According to the model, 1,000 adults in a health plan with 1 million adult members annually present with symptoms of major depressive disorder. An additional 38 patients were correctly diagnosed with depression (unipolar or a major depressive episode) or bipolar disorder (440 with screening vs 402 without screening) through a 1-time screening for bipolar disorder. Estimated 5-year discounted costs per patient were $36,044 without screening and $34,107 with screening (savings of $1,937). Accordingly, total 5-year budgetary savings were estimated at $1.94 million. Results were most sensitive to difference in treatment costs for patients with recognized versus unrecognized bipolar disorder. CONCLUSION: A 1-time screening program for bipolar disorder, when patients first present with a major depressive episode, can reduce health care costs to managed-care plans.
BT - The Journal of clinical psychiatry
C5 - Financing & Sustainability
CP - 9
CY - United States
DO - 10.4088/JCP.08m04939
IS - 9
JF - The Journal of clinical psychiatry
N2 - OBJECTIVE: Unrecognized bipolar disorder in patients presenting with a major depressive episode may lead to delayed diagnosis, inappropriate treatment, and excessive costs. This study models the cost effectiveness of screening for bipolar disorder among adults presenting for the first time with symptoms of major depressive disorder. METHOD: A decision-analysis model was used to evaluate the outcomes and cost over 5 years of screening versus not screening for bipolar disorder. Screening was defined as a 1-time administration of the Mood Disorder Questionnaire at the initial visit followed by referral to a psychiatrist for patients screening positive for bipolar disorder. Health states included correctly diagnosed bipolar disorder, unrecognized bipolar disorder, and correctly diagnosed major depressive episodes. Model outcomes included rates of correct diagnosis of bipolar disorder and discounted costs (2006 US dollars) of screening and treating major depressive episodes. Literature was the primary source of data and was collected from September 2007 through March 2009. RESULTS: According to the model, 1,000 adults in a health plan with 1 million adult members annually present with symptoms of major depressive disorder. An additional 38 patients were correctly diagnosed with depression (unipolar or a major depressive episode) or bipolar disorder (440 with screening vs 402 without screening) through a 1-time screening for bipolar disorder. Estimated 5-year discounted costs per patient were $36,044 without screening and $34,107 with screening (savings of $1,937). Accordingly, total 5-year budgetary savings were estimated at $1.94 million. Results were most sensitive to difference in treatment costs for patients with recognized versus unrecognized bipolar disorder. CONCLUSION: A 1-time screening program for bipolar disorder, when patients first present with a major depressive episode, can reduce health care costs to managed-care plans.
PB - Physicians Postgraduate Press, Inc
PP - United States
PY - 2009
SN - 1555-2101; 0160-6689
SP - 1230
EP - 1236
EP - 
T1 - A model of the economic impact of a bipolar disorder screening program in primary care
T2 - The Journal of clinical psychiatry
TI - A model of the economic impact of a bipolar disorder screening program in primary care
U1 - Financing & Sustainability
U2 - 19689919
U3 - 10.4088/JCP.08m04939
VL - 70
VO - 1555-2101; 0160-6689
Y1 - 2009
ER -