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.
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).
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.
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.
Mots-clés Pascal : Etat dépressif, Trouble humeur, Soin santé primaire, Utilisation, Service santé, Diagnostic, Analyse coût, Economie santé, Santé mentale, Etats Unis, Amérique du Nord, Amérique, Homme, Association morbide, Maladie, Santé physique
Mots-clés Pascal anglais : Depression, Mood disorder, Primary health care, Use, Health service, Diagnosis, Cost analysis, Health economy, Mental health, United States, North America, America, Human, Concomitant disease, Disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0566331
Code Inist : 002B18H05B. Création : 01/03/1996.