Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Patient and Family Support Services, Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.
Psychooncology. 2018 Jul;27(7):1735-1741. doi: 10.1002/pon.4716. Epub 2018 Apr 25.
Depression is common among patients diagnosed with cancer. Patients with cancer and depression use more health care services compared with nondepressed cancer patients. The current study seeks to estimate the added cost of depression in cancer patients in the first year after cancer diagnosis.
Health care charges were obtained for 2051 depressed and 11 182 nondepressed patients with an International Classification of Diseases, Ninth Revision, diagnosis of cancer in the 2014 calendar year from the University of California San Diego Healthcare System. The annual health care charges for cancer patients with and without depression were analyzed using generalized linear models with a log-link function and gamma distribution, covarying for age, sex, race/ethnicity, comorbid diseases, and presence of metastatic disease. Total cost data were broken down into several categories including ambulatory care, emergency department visits, and hospital visits.
Depressed cancer patients had total annual health care charges that were 113% higher than nondepressed cancer patients (B = 0.76; P < .001). The estimated mean charges for depressed patients were $235 337 compared with $110 650 for nondepressed patients. Depressed cancer patients incurred greater charges than nondepressed patients in ambulatory care (B = 0.70; P < .001), emergency department charges (B = 0.31; P < .001), and hospital charges (B = 0.39; P < .001).
Depressed cancer patients incur significantly higher health care charges across multiple cost categories including ambulatory care, emergency department visits, and hospital visits. Future research should investigate if interventions for detecting and treating depression are effective for reducing health care use and costs in cancer patients.
癌症患者中普遍存在抑郁症状。与无抑郁的癌症患者相比,患有癌症和抑郁症的患者使用更多的医疗保健服务。本研究旨在估算癌症患者在确诊后第一年因抑郁而增加的成本。
从加利福尼亚大学圣地亚哥医疗保健系统获取了 2051 名患有抑郁症和 11182 名无抑郁症的癌症患者在 2014 年的医疗保健费用,这些患者的国际疾病分类第 9 版诊断为癌症。使用具有对数链接函数和伽马分布的广义线性模型分析有和无抑郁的癌症患者的年度医疗保健费用,同时协变量包括年龄、性别、种族/民族、合并症和转移性疾病的存在。将总费用数据细分为几个类别,包括门诊护理、急诊就诊和住院就诊。
患有抑郁症的癌症患者的年度医疗保健总费用比无抑郁症的癌症患者高 113%(B=0.76;P<0.001)。抑郁患者的估计平均费用为 235337 美元,而无抑郁患者的费用为 110650 美元。与无抑郁患者相比,抑郁癌症患者在门诊护理(B=0.70;P<0.001)、急诊就诊(B=0.31;P<0.001)和住院就诊(B=0.39;P<0.001)方面的费用更高。
患有抑郁症的癌症患者在多个成本类别(包括门诊护理、急诊就诊和住院就诊)的医疗保健费用显著更高。未来的研究应调查针对检测和治疗抑郁症的干预措施是否能有效减少癌症患者的医疗保健使用和成本。