Direct costs associated with depressive symptoms in late life: a 4.5-year prospective study

TY - JOUR

T1 - Direct costs associated with depressive symptoms in late life: a 4.5-year prospective study

AU - Luppa, Melanie

AU - König, Hans-Helmut

AU - Heider, Dirk

AU - Leicht, Hanna

AU - Motzek, Tom

AU - Schomerus, Georg

AU - Riedel-Heller, Steffi G

PY - 2013

Y1 - 2013

N2 - BACKGROUND: Depression in old age is common. Only few studies examined the association of depressive symptoms and direct costs in the elderly in a cross-sectional way. This study aims to investigate prospectively health service use and direct costs over a course of 4.5 years considering also different courses of depressive symptomatology.METHODS: 305 primary care patients aged 75+ were assessed face-to-face regarding depressive symptoms (Geriatric Depression Scale), and service use and costs at baseline and 4.5 years later. Resource utilization was monetarily valued using 2004/2005 prices. The association of baseline factors and direct costs after 4.5 years was analyzed by multivariate linear regression.RESULTS: Mean annual direct costs of depressed individuals at baseline and follow-up were almost one-third higher than of non-depressed, and highest for individuals with chronic depressive symptoms. Most relevant cost drivers were costs for inpatient care, pharmaceuticals, and home care. Costs for home care increased at most in individuals with chronic depressive symptoms. Baseline variables that were associated with direct costs after 4.5 years were number of medications as a measure of comorbidity, age, gender, and depressive symptoms.CONCLUSIONS: Presence and persistence of depressive symptoms in old age seems to be associated with future direct costs even after adjustment for comorbidity. The findings deign a look to the potential economic consequences of depressive symptoms in the elderly for the healthcare system in the future.

AB - BACKGROUND: Depression in old age is common. Only few studies examined the association of depressive symptoms and direct costs in the elderly in a cross-sectional way. This study aims to investigate prospectively health service use and direct costs over a course of 4.5 years considering also different courses of depressive symptomatology.METHODS: 305 primary care patients aged 75+ were assessed face-to-face regarding depressive symptoms (Geriatric Depression Scale), and service use and costs at baseline and 4.5 years later. Resource utilization was monetarily valued using 2004/2005 prices. The association of baseline factors and direct costs after 4.5 years was analyzed by multivariate linear regression.RESULTS: Mean annual direct costs of depressed individuals at baseline and follow-up were almost one-third higher than of non-depressed, and highest for individuals with chronic depressive symptoms. Most relevant cost drivers were costs for inpatient care, pharmaceuticals, and home care. Costs for home care increased at most in individuals with chronic depressive symptoms. Baseline variables that were associated with direct costs after 4.5 years were number of medications as a measure of comorbidity, age, gender, and depressive symptoms.CONCLUSIONS: Presence and persistence of depressive symptoms in old age seems to be associated with future direct costs even after adjustment for comorbidity. The findings deign a look to the potential economic consequences of depressive symptoms in the elderly for the healthcare system in the future.

U2 - 10.1017/S1041610212001688

DO - 10.1017/S1041610212001688

M3 - SCORING: Journal article

C2 - 23083505

VL - 25

SP - 292

EP - 302

JO - INT PSYCHOGERIATR

JF - INT PSYCHOGERIATR

SN - 1041-6102

IS - 2

M1 - 2

ER -