TY - JOUR
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Convalescence
KW - Depressive Disorder, Major/economics/epidemiology/therapy
KW - Efficiency
KW - Female
KW - Follow-Up Studies
KW - Health Care Costs
KW - Humans
KW - Male
KW - Middle Aged
KW - Primary Health Care/economics
KW - Treatment Outcome
KW - Work
AU - G. E. Simon
AU - D. Revicki
AU - J. Heiligenstein
AU - L. Grothaus
AU - M. Von Korff
AU - W. J. Katon
AU - T. R. Hylan
A1 - 
AB - We describe a secondary analysis of data from a randomized trial conducted at seven primary care clinics of a Seattle area HMO. Adults with major depression (n=290) beginning antidepressant treatment completed structured interviews at baseline, 1, 3, 6, 9, 12, 18, and 24 months. Interviews examined clinical outcomes (Hamilton Depression Rating Scale and depression module of the Structured Clinical Interview for DSM-IIIR), employment status, and work days missed due to illness. Medical comorbidity was assessed using computerized pharmacy data, and medical costs were assessed using the HMO's computerized accounting data. Using data from the 12-month assessment, patients were classified as remitted (41%), improved but not remitted (47%), and persistently depressed (12%). After adjustment for depression severity and medical comorbidity at baseline, patients with greater clinical improvement were more likely to maintain paid employment (P=.007) and reported fewer days missed from work due to illness (P<.001). Patients with better 12-month clinical outcomes had marginally lower health care costs during the second year of follow-up (P=.06). We conclude that recovery from depression is associated with significant reductions in work disability and possible reductions in health care costs. Although observational data cannot definitively prove any causal relationships, these longitudinal results strengthen previous findings regarding the economic burden of depression on employers and health insurers.
BT - General hospital psychiatry
C5 - Financing & Sustainability
CP - 3
CY - UNITED STATES
IS - 3
JF - General hospital psychiatry
N2 - We describe a secondary analysis of data from a randomized trial conducted at seven primary care clinics of a Seattle area HMO. Adults with major depression (n=290) beginning antidepressant treatment completed structured interviews at baseline, 1, 3, 6, 9, 12, 18, and 24 months. Interviews examined clinical outcomes (Hamilton Depression Rating Scale and depression module of the Structured Clinical Interview for DSM-IIIR), employment status, and work days missed due to illness. Medical comorbidity was assessed using computerized pharmacy data, and medical costs were assessed using the HMO's computerized accounting data. Using data from the 12-month assessment, patients were classified as remitted (41%), improved but not remitted (47%), and persistently depressed (12%). After adjustment for depression severity and medical comorbidity at baseline, patients with greater clinical improvement were more likely to maintain paid employment (P=.007) and reported fewer days missed from work due to illness (P<.001). Patients with better 12-month clinical outcomes had marginally lower health care costs during the second year of follow-up (P=.06). We conclude that recovery from depression is associated with significant reductions in work disability and possible reductions in health care costs. Although observational data cannot definitively prove any causal relationships, these longitudinal results strengthen previous findings regarding the economic burden of depression on employers and health insurers.
PP - UNITED STATES
PY - 2000
SN - 0163-8343; 0163-8343
SP - 153
EP - 162
EP - 
T1 - Recovery from depression, work productivity, and health care costs among primary care patients
T2 - General hospital psychiatry
TI - Recovery from depression, work productivity, and health care costs among primary care patients
U1 - Financing & Sustainability
U2 - 10880708
VL - 22
VO - 0163-8343; 0163-8343
Y1 - 2000
ER -