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. 2011 May;17(5):319-28.

Psychological distress and trends in healthcare expenditures and outpatient healthcare

Paul A Pirraglia  1 , John M Hampton, Allison B Rosen, Whitney P Witt
Affiliations

Psychological distress and trends in healthcare expenditures and outpatient healthcare

Paul A Pirraglia et al. Am J Manag Care. 2011 May.

Abstract

Objectives: To determine whether trends in psychological distress exist in the United States and whether trends in healthcare expenditures and outpatient visits were associated with psychological distress.

Study design: Sequential cross-sectional study of nationally representative data.

Methods: We examined data from the National Health Interview Survey (NHIS) from 1997 to 2004 linked to 2 years of subsequent Medical Expenditure Panel Survey (MEPS) data. Psychological distress was measured in the NHIS using the K6, a 6-item scale of the Kessler Psychological Distress Scale, which we classified as no/low, mild-moderate, or severe. We examined subsequent annualized total, outpatient, and office-based expenditures, and outpatient and office-based visits from MEPS.

Results: Psychological distress remained stable from 1997 to 2004. There were upward trends in overall healthcare expenditures (P <.001) and outpatient expenditures (P <.001), but not outpatient visits. Overall healthcare expenditures, outpatient expenditures, and outpatient visits significantly increased as psychological distress increased from no/low to mild-moderate to severe. The interaction between psychological distress strata and year was not significant for expenditures or for visits.

Conclusions: The upward trend in total and outpatient healthcare expenditures in the United States appears unrelated to psychological distress, although healthcare expenditures are consistently higher among those with greater psychological distress. Future work will explore the impact of treatment on costs and stability of the nation's mental health over time.

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Conflict of interest statement

Author Disclosures: The authors (PAP, JMH, ABR, WPW) report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Figures

Figure
Figure
Strata of Psychological Distress (No/Low, Mild-Moderate, Severe) Versus Subsequent Total Expenditures (Panel A), Outpatient and Office-Based Expenditures (Panel B), and Outpatient and Office Visits (Panel C)a aPanel A shows unadjusted mean annualized total per person expenditures by strata of psychological distress. Panel B displays unadjusted mean annualized outpatient and office-based per person expenditures by strata of psychological distress. Panel C shows mean annualized outpatient and office-based per person visits. Note that the dates correspond to the year in which psychological distress was measured in National Health Interview Survey, while the annualized expenditures and visits were determined from the Medical Expenditure Panel Survey data in the 2 years following the index year.
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References

    1. Stanton MW. Research in Action. Issue 19. Rockville, MD: Agency for Healthcare Research and Quality; 2006. Jun, [Accessed April 15, 2011]. The high concentration of U.S. health care expenditures. AHRQ publication 06-0060. http://www.ahrq.gov/research/ria19/expendria.htm.
    1. Levit K, Smith C, Cowan C, Lazenby H, Sensenig A, Catlin A. Trends in U.S. health care spending, 2001. Health Aff (Millwood) 2003;22(1):154–164. - PubMed
    1. Levit KR, Kassed CA, Coffey RM, et al. Projections of National Expenditures for Mental Health Services and Substance Abuse Treatment, 2004h–2014h. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2008. SAMHSA publication SMA 08-4h326.
    1. Zuvekas SH. Prescription drugs and the changing patterns of treatment for mental disorders, 1996–2001. Health Aff (Millwood) 2005;24(1):195–205. - PubMed
    1. 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):352–357. - PubMed

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