Depression and Healthcare Service Utilization in Patients with Cancer

Overview

Journal Psychooncology

Publisher Wiley

Specialties Oncology
Psychology

Date 2016 Apr 23

PMID 27102731

Citations 43

Authors

Brent T Mausbach

Scott A Irwin

Affiliations

Soon will be listed here.

Abstract

Objective: It is estimated that as many as 38% of cancer patients suffer from depression, which may have distal impacts on cancer care, including clinical outcomes, health care utilization, and cost of care. The purpose of this study was to determine the impact of depression on overall healthcare utilization among patients with cancer.

Methods: A retrospective analysis of administrative data was conducted on 5055 patients with an ICD-9 diagnosis of cancer from a single large healthcare system. Of these, 561 (11.1%) had ICD-9 diagnoses consistent with a depressive disorder. Negative binomial regression modeling was used to test the association between depression status and total annual healthcare visits for the year 2011. Logistic regression was used to examine the association between depression and secondary outcomes of emergency department visit, overnight hospitalization, and 30-day hospital readmission.

Results: After adjusting for age, gender, race/ethnicity, insurance type, medical comorbidities, length of time with cancer, and metastatic status, depressed patients had significantly more annual non-mental health provider healthcare visits (aRR = 1.76, 95% CI = 1.61-1.93), and were significantly more likely to have an ED visit (OR = 2.45; 95% CI = 1.97-3.04), overnight hospitalization (OR = 1.81; 95% CI = 1.49-2.20), and 30-day hospital readmission (OR = 2.03; 95% CI = 1.48-2.79) than non-depressed patients with cancer.

Conclusions: Among patients with cancer, the presence of depression was associated with greater healthcare utilization. Effective screening for, and management of, depression may help reduce overall healthcare utilization and cost while improving care quality. Copyright © 2016 John Wiley & Sons, Ltd.

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References

Luber M, Hollenberg J, DiDomenico T, Meyers B, Alexopoulos G, Charlson M . Diagnosis, treatment, comorbidity, and resource utilization of depressed patients in a general medical practice. Int J Psychiatry Med. 2000; 30(1):1-13. DOI: 10.2190/YTRY-E86M-G1VC-LC79. View

Prina A, Huisman M, Yeap B, Hankey G, Flicker L, Brayne C . Association between depression and hospital outcomes among older men. CMAJ. 2012; 185(2):117-23. PMC: 3563884. DOI: 10.1503/cmaj.121171. View

Kessler R, Berglund P, Demler O, Jin R, Koretz D, Merikangas K . The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003; 289(23):3095-105. DOI: 10.1001/jama.289.23.3095. View

Himelhoch S, Weller W, Wu A, Anderson G, Cooper L . Chronic medical illness, depression, and use of acute medical services among Medicare beneficiaries. Med Care. 2004; 42(6):512-21. DOI: 10.1097/01.mlr.0000127998.89246.ef. View

Druss B, Rosenheck R, Sledge W . Health and disability costs of depressive illness in a major U.S. corporation. Am J Psychiatry. 2000; 157(8):1274-8. DOI: 10.1176/appi.ajp.157.8.1274. View

Charlson M, Szatrowski T, Peterson J, Gold J . Validation of a combined comorbidity index. J Clin Epidemiol. 1994; 47(11):1245-51. DOI: 10.1016/0895-4356(94)90129-5. View

Cohen J . A power primer. Psychol Bull. 2009; 112(1):155-9. DOI: 10.1037//0033-2909.112.1.155. View

Ansseau M, Dierick M, Buntinkx F, Cnockaert P, De Smedt J, Van Den Haute M . High prevalence of mental disorders in primary care. J Affect Disord. 2003; 78(1):49-55. DOI: 10.1016/s0165-0327(02)00219-7. View

Cipriani A, Furukawa T, Salanti G, Geddes J, Higgins J, Churchill R . Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009; 373(9665):746-58. DOI: 10.1016/S0140-6736(09)60046-5. View

10.

Prina A, Cosco T, Dening T, Beekman A, Brayne C, Huisman M . The association between depressive symptoms in the community, non-psychiatric hospital admission and hospital outcomes: a systematic review. J Psychosom Res. 2014; 78(1):25-33. PMC: 4292984. DOI: 10.1016/j.jpsychores.2014.11.002. View

11.

Huang A, Delucchi K, Dunn L, Nelson J . A systematic review and meta-analysis of psychotherapy for late-life depression. Am J Geriatr Psychiatry. 2014; 23(3):261-73. DOI: 10.1016/j.jagp.2014.04.003. View

12.

Simon G, Ormel J, VonKorff M, BARLOW W . Health care costs associated with depressive and anxiety disorders in primary care. Am J Psychiatry. 1995; 152(3):352-7. DOI: 10.1176/ajp.152.3.352. View

13.

Kroenke K . Patients presenting with somatic complaints: epidemiology, psychiatric comorbidity and management. Int J Methods Psychiatr Res. 2003; 12(1):34-43. PMC: 6878426. DOI: 10.1002/mpr.140. View

14.

Callahan C, Kesterson J, Tierney W . Association of symptoms of depression with diagnostic test charges among older adults. Ann Intern Med. 1997; 126(6):426-32. DOI: 10.7326/0003-4819-126-6-199703150-00002. View

15.

Luber M, Meyers B, Hollenberg J, DiDomenico T, Charlson M, Alexopoulos G . Depression and service utilization in elderly primary care patients. Am J Geriatr Psychiatry. 2001; 9(2):169-76. View

16.

Watson M, Haviland J, Greer S, Davidson J, Bliss J . Influence of psychological response on survival in breast cancer: a population-based cohort study. Lancet. 1999; 354(9187):1331-6. DOI: 10.1016/s0140-6736(98)11392-2. View

17.

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

18.

Cuijpers P, Berking M, Andersson G, Quigley L, Kleiboer A, Dobson K . A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Can J Psychiatry. 2013; 58(7):376-85. DOI: 10.1177/070674371305800702. View

19.

Laoutidis Z, Mathiak K . Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. BMC Psychiatry. 2013; 13:140. PMC: 3674917. DOI: 10.1186/1471-244X-13-140. View

20.

Katzelnick D, Kobak K, Greist J, Jefferson J, Henk H . Effect of primary care treatment of depression on service use by patients with high medical expenditures. Psychiatr Serv. 1997; 48(1):59-64. DOI: 10.1176/ps.48.1.59. View