Bock Jens-Oliver, Hajek André, Weyerer Siegfried, Werle Jochen, Wagner Michael, Maier Wolfgang, Stark Anne, Kaduszkiewicz Hanna, Wiese Birgitt, Moor Lilia, Stein Janine, Riedel-Heller Steffi G, König Hans-Helmut
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg, Germany.
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg, Germany.
Am J Geriatr Psychiatry. 2017 Feb;25(2):131-141. doi: 10.1016/j.jagp.2016.10.011. Epub 2016 Nov 2.
To examine whether depressive symptoms affect healthcare costs in old age longitudinally.
Multicenter prospective observational cohort study (two waves with n = 1,195 and n = 951) in Germany.
Community.
Participants aged 75 years and older recruited via general practitioners.
Depressive symptoms were assessed by the Geriatric Depression Scale (GDS). The health-related resource use was measured retrospectively from a societal perspective based on a questionnaire, covering outpatient services, inpatient treatment, pharmaceuticals, as well as formal and informal nursing care. Hybrid regression models were used to determine the between- and within-effect of depressive symptoms on healthcare costs, adjusting for important covariates.
Six-month total cost increased from €3,090 (t1) to €3,748 (t2). The hybrid random effects models showed that individuals with more depressive symptoms had higher healthcare costs compared with individuals with less depressive symptoms (between-effect). Moreover, an intra-individual increase in depressive symptoms increased healthcare costs by €539.60 (within-effect) per symptom on GDS.
Our findings emphasize the economic importance of depressive symptoms in old age. Appropriate interventions to treat depressive symptoms in old age might also be a promising strategy to reduce healthcare costs.
纵向研究抑郁症状是否会影响老年人的医疗保健费用。
德国的多中心前瞻性观察队列研究(两波,n = 1195和n = 951)。
社区。
通过全科医生招募的75岁及以上的参与者。
使用老年抑郁量表(GDS)评估抑郁症状。从社会角度基于问卷回顾性测量与健康相关的资源使用情况,涵盖门诊服务、住院治疗、药品以及正式和非正式护理。使用混合回归模型确定抑郁症状对医疗保健费用的组间和组内效应,并对重要协变量进行调整。
六个月的总成本从3090欧元(t1)增加到3748欧元(t2)。混合随机效应模型显示,与抑郁症状较轻的个体相比,抑郁症状较多的个体医疗保健费用更高(组间效应)。此外,个体抑郁症状的增加使GDS上每个症状的医疗保健费用增加539.60欧元(组内效应)。
我们的研究结果强调了老年抑郁症状的经济重要性。针对老年抑郁症状进行适当干预可能也是降低医疗保健费用的一种有前景的策略。