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

Published online by Cambridge University Press:  19 October 2012

Melanie Luppa ,
Hans-Helmut König ,
Dirk Heider ,
Hanna Leicht ,
Tom Motzek ,
Georg Schomerus  and
Steffi G. Riedel-Heller
Melanie Luppa*
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
Hans-Helmut König
Affiliation:
Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Dirk Heider
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Hanna Leicht
Affiliation:
Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Tom Motzek
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
Georg Schomerus
Affiliation:
Department of Psychiatry, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
Steffi G. Riedel-Heller
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
*
Correspondence should be addressed to: Melanie Luppa, Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Philipp-Rosenthal-Straße 55, D-04103 Leipzig, Germany. Phone: +49-341-9724534; Fax: +49-341-9715409. Email: [email protected].
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Abstract

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.

Keywords

costseconomic burdenservice usedepressiondepressive symptoms
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 2 , February 2013 , pp. 292 - 302
Copyright
Copyright © International Psychogeriatric Association 2012

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