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. 2017 Sep 5;12(9):e0184268.
doi: 10.1371/journal.pone.0184268. eCollection 2017.

The direct healthcare costs associated with psychological distress and major depression: A population-based cohort study in Ontario, Canada

Maria Chiu  1   2 , Michael Lebenbaum  1 , Joyce Cheng  3 , Claire de Oliveira  1   2   3 , Paul Kurdyak  1   2   3
Affiliations

The direct healthcare costs associated with psychological distress and major depression: A population-based cohort study in Ontario, Canada

Maria Chiu et al. PLoS One. .

Abstract

The objective of our study was to estimate direct healthcare costs incurred by a population-based sample of people with psychological distress or depression. We used the 2002 Canadian Community Health Survey on Mental Health and Well Being and categorized individuals as having psychological distress using the Kessler-6, major depressive disorder (MDD) using DSM-IV criteria and a comparison group of participants without MDD or psychological distress. Costs in 2013 USD were estimated by linking individuals to health administrative databases and following them until March 31, 2013. Our sample consisted of 9,965 individuals, of whom 651 and 409 had psychological distress and MDD, respectively. Although the age-and-sex adjusted per-capita costs were similarly high among the psychologically distressed ($3,364, 95% CI: $2,791, $3,937) and those with MDD ($3,210, 95% CI: $2,413, $4,008) compared to the comparison group ($2,629, 95% CI: $2,312, $2,945), the population-wide excess costs for psychological distress ($441 million) were more than twice that for MDD ($210 million) as there was a greater number of people with psychological distress than depression. We found substantial healthcare costs associated with psychological distress and depression, suggesting that psychological distress and MDD have a high cost burden and there may be public health intervention opportunities to relieve distress. Further research examining how individuals with these conditions use the healthcare system may provide insight into the allocation of limited healthcare resources while maintaining high quality care.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Population-wide annual absolute (Panel A) and excess (Panel B) direct health care costs (2013 USD) incurred by people with psychological distress and depression in Ontario, Canadaa.
a All values weighted by sample weights. Analyses were adjusted for age and sex. Bootstrap methods were used to determine the 95% confidence intervals (i.e. the 2.5th and 97.5th percentiles of 500 bootstrap estimates).
See this image and copyright information in PMC

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