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. 2020 May;65(5):338-346.
doi: 10.1177/0706743719895342. Epub 2019 Dec 13.

Economic Burden of Depression and Associated Resource Use in Manitoba, Canada

Julie-Anne Tanner  1   2   3 , Jennifer Hensel  4 , Paige E Davies  3 , Lisa C Brown  5 , Bryan M Dechairo  6 , Benoit H Mulsant  7
Affiliations

Economic Burden of Depression and Associated Resource Use in Manitoba, Canada

Julie-Anne Tanner et al. Can J Psychiatry. 2020 May.

Abstract
in English, French

Objectives: To characterize the health-care utilization and economic burden associated with depression in Manitoba, Canada.

Methods: Patient-level data were retrieved from the Manitoba Centre for Health Policy administrative, clinical, and laboratory databases for the study period of January 1, 1996, through December 31, 2016. Patients were assigned to the depression cohort based on diagnoses recorded in hospitalizations and outpatient physician claims, as well as antidepressant prescription drug claims. A comparison cohort of nondepressed subjects, matched with replacement for age, gender, place of residence (urban vs. rural), and index date, was created. Demographics, comorbidities, intentional self-harm, mortality, health-care utilization, prescription drug utilization, and costs of health-care utilization and social services were compared between depressed patients and matched nondepressed patients, and incidence rate ratios and hazard ratios were reported.

Results: There were 190,065 patients in the depression cohort and 378,177 patients in the nondepression cohort. Comorbidities were 43% more prevalent among depressed patients. Intentional self-harm, all-cause mortality, and suicide mortality were higher among patients with depression than the nondepression cohort. Health-care utilization-including hospitalizations, physician visits, physician-provided psychotherapy, and prescription drugs-was higher in the depression than the nondepression cohort. Mean health-care utilization costs were 3.5 times higher among depressed patients than nondepressed patients ($10,064 and $2,832, respectively). Similarly, mean social services costs were 3 times higher ($1,522 and $510, respectively). Overall, depression adds a total average cost of $8,244 (SD = $40,542) per person per year.

Conclusions: Depression contributes significantly to health burden and per patient costs in Manitoba, Canada. Extrapolation of the results to the entire Canadian health-care system projects an excess of $12 billion annually in health system spending.

Objectifs: Caractériser l’utilisation des soins de santé et la charge économique associées à la dépression au Manitoba, Canada.

Méthodes: Les données sur les patients ont été extraites des bases de données administratives, cliniques et de laboratoire du Centre des politiques de santé du Manitoba pour la période de l’étude, du 1er janvier 1996 au 31 décembre 2016. Les patients ont été affectés à la cohorte de la dépression en fonction des diagnostics enregistrés lors des hospitalisations et des factures des médecins des services ambulatoires, ainsi que des demandes de remboursement des ordonnances de médicaments antidépresseurs. Une cohorte de comparaison de sujets non dépressifs, appariés en remplacement pour l’âge, le sexe, le lieu de résidence (urbain contre rural), et la date de début a été créée. Les données démographiques, les comorbidités, l’automutilation intentionnelle, la mortalité, l’utilisation des soins de santé, l’utilisation de médicaments sur ordonnance, et les coûts de l’utilisation des soins de santé et des services sociaux ont été comparés entre les patients déprimés et les patients appariés non déprimés, et les rapports des taux d’incidence ainsi que les rapports de risque ont été signalés.

Résultats: Il y avait 190 065 patients dans la cohorte de la dépression et 378 177 patients dans la cohorte de non-dépression. Les comorbidités étaient 43% plus prévalentes chez les patients déprimés. L’automutilation intentionnelle, la mortalité pour toutes causes, et la mortalité par suicide étaient plus élevées chez les patients souffrant de dépression que dans la cohorte de non-dépression. L’utilisation des soins de santé – notamment les hospitalisations, les visites au médecin, la psychothérapie donnée par un médecin, et les médicaments sur ordonnance – était plus élevée dans la cohorte de la dépression que dans celle de la non-dépression. Les coûts moyens de l’utilisation des soins de santé étaient 3,5 fois plus élevés chez les patients déprimés que chez ceux non déprimés (10 064 $ et 2 832 $, respectivement). De même, les coûts moyens des services sociaux étaient 3 fois plus élevés (1 522 $ et 510 $, respectivement). En tout, la dépression ajoute un coût moyen total de 8 244 $ (ET 40 542 $) par personne, par année.

Conclusions: La dépression contribue significativement à la charge de la santé et aux coûts par patient au Manitoba, Canada. L’extrapolation des résultats à tout le système de santé canadien projette un excès de 12 milliards de dollars annuellement aux dépenses du système de santé.

Keywords: cost; depression; economic burden; health-care utilization; mortality; suicide.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JAT, PED, LCB, and BMD were employed by Assurex Health/Myriad at the time of the study and received stock options as part of their compensation. During the past 5 years, BHM has received research funding from Brain Canada, the CAMH Foundation, the Canadian Institutes of Health Research, and the U.S. National Institutes of Health (NIH); research support from Bristol-Myers Squibb (medications for a NIH-funded clinical trial), Eli-Lilly (medications for a NIH-funded clinical trial), Pfizer (medications for a NIH-funded clinical trial), Capital Solution Design LLC (software used in a study funded by CAMH Foundation), and HAPPYneuron (software used in a study funded by Brain Canada). The remaining authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
The mean (A) direct medical and (B) social service costs (2018 CAD) per patient per year during the entire follow-up period. CAD = Canadian dollar.
See this image and copyright information in PMC

Comment in

References

    1. Ratnasingham S, Cairney J, Manson H, Rehm J, Lin E, Kurdyak P. The burden of mental illness and addiction in Ontario. Can J Psychiatry. 2013;58(9):529–537. - PubMed
    1. Lim KL, Jacobs P, Ohinmaa A, Schopflocher D, Dewa CS. A new population-based measure of the economic burden of mental illness in Canada. Chronic Dis Can. 2008;28(3):92–98. - PubMed
    1. Claire de Oliveira JC, Rehm J, Kurdyak P. The role of mental health and addiction among high-cost patients: a population-based study. J Med Econ. 2018;12(4):348–355. - PubMed
    1. de Oliveira C, Cheng J, Vigod S, Rehm J, Kurdyak P. Patients with high mental health costs incur over 30 percent more costs than other high-cost patients. Health Aff (Project Hope). 2016;35(1):36–43. - PubMed
    1. Hensel JM, Taylor VH, Fung K, Vigod SN. Rates of mental illness and addiction among high-cost users of medical services in Ontario. Can J Psychiatry. 2016;61(6):358–366. - PMC - PubMed

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