Cost Eff Resour Alloc. 2007 Apr 18;5:4. doi: 10.1186/1478-7547-5-4.
Diabetes, minor depression and health care utilization and expenditures: a retrospective database study.
Cost effectiveness and resource allocation : C/E
Lori Nichols, Phoebe L Barton, Judith Glazner, Marianne McCollum
Affiliations
Affiliations
- Department of Preventive Medicine and Biometrics, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA.
- Department of Clinical Pharmacy, University of Colorado at Denver and Health Sciences Center, 4200 East Ninth Ave., Box C-238, Denver, Colorado, 80262 USA.
PMID: 17442110
PMCID: PMC1863422 DOI: 10.1186/1478-7547-5-4
Abstract
BACKGROUND: To estimate the prevalence of minor depression among US adults with diabetes, health care resource utilization, and expenditures by people with diabetes with and without minor depression.
METHODS: Among adult 2003 Medical Expenditure Panel Survey respondents, diabetes was identified by diagnosis code and self-report. Depression was identified by diagnosis code plus > or = one antidepressant prescription. Odds of having depression was estimated in people with diabetes and the general population, adjusted for sociodemographic variables (e.g., age, sex, race/ethnicity). Multivariate regressions evaluated factors associated with utilization and log-transformed expenditures for ambulatory care, hospitalizations, emergency visits, and prescriptions.
RESULTS: In 2003, 1932 respondents had diabetes, 435/1932 had diabetes and minor depression. Adults with diabetes were more likely than the general population to have depression (adjusted OR 1.81, 95% CI 1.56, 2.09). People with diabetes with versus without comorbid depression were more likely to be women, have lower incomes and health status, and more diabetes complications (all p < 0.05). In unadjusted analyses, ambulatory care visits were higher for those with versus without depression (17.9 vs. 11.4, p = 0.04), as were prescriptions (60.7 vs. 38.1, p = 0.05). In adjusted analyses, depression was not associated with increased resource use or higher expenditures in any category. Increased number of comorbid conditions was associated with increased resource use in all categories, and increased expenditures for ambulatory care and prescriptions.
CONCLUSION: People with diabetes are twice as likely to have depression as the general population. Screening for and treatment of depression is warranted, as is additional research into a causal relationship between diabetes and depression.
References
- Diabetes Care. 2000 Jul;23(7):934-42 - PubMed
- Arch Intern Med. 2000 Nov 27;160(21):3278-85 - PubMed
- Diabetes Care. 2001 Jun;24(6):1069-78 - PubMed
- Am J Epidemiol. 2001 Nov 1;154(9):854-64 - PubMed
- Diabetes Care. 2002 Mar;25(3):464-70 - PubMed
- Diabetes Care. 2003 Feb;26(2):415-20 - PubMed
- Diabetes Care. 2003 Mar;26(3):917-32 - PubMed
- Int J Methods Psychiatr Res. 2003;12(1):22-33 - PubMed
- Gen Hosp Psychiatry. 2003 Jul-Aug;25(4):246-52 - PubMed
- Med Care. 2003 Nov;41(11):1284-92 - PubMed
- BMJ. 2003 Nov 15;327(7424):1144-6 - PubMed
- J Clin Psychiatry. 2003 Dec;64(12):1465-75 - PubMed
- Diabetes Care. 2004 Apr;27(4):914-20 - PubMed
- J Natl Med Assoc. 2004 Apr;96(4):476-84 - PubMed
- J Clin Epidemiol. 2004 Sep;57(9):978-84 - PubMed
- Am J Epidemiol. 2005 Apr 1;161(7):652-60 - PubMed
- Diabetes Care. 2007 Jan;30 Suppl 1:S4-S41 - PubMed
- Am J Manag Care. 2007 Feb;13(2):65-72 - PubMed
- Perm J. 2004 Fall;8(4):24-6 - PubMed
- Diabetes Care. 1993 Aug;16(8):1167-78 - PubMed
- Med Care. 1996 Mar;34(3):220-33 - PubMed
Publication Types