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商业保险覆盖人群中与产后抑郁症相关的医疗资源利用和成本。

Healthcare resource utilization and costs associated with postpartum depression among commercially insured households.

机构信息

Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.

Health Economics Outcomes Research, Sage Therapeutics, Inc, Cambridge, MA, USA.

出版信息

Curr Med Res Opin. 2020 Oct;36(10):1707-1716. doi: 10.1080/03007995.2020.1799772. Epub 2020 Aug 7.

Abstract

OBJECTIVE

To quantify the economic burden of postpartum depression (PPD) that accrues to commercially insured households in the year following childbirth.

METHODS

Administrative claims data from OptumHealth Care Solutions (2009-2016) were used to identify households that included women identified with PPD per the algorithm and propensity score-matched comparison households of women who were not identified with PPD or a history of depression after childbirth. Study outcomes included direct total all-cause medical and pharmaceutical costs during the first year following childbirth and number of outpatient visits at the household level stratified by household member.

RESULTS

Households affected by PPD as identified by the algorithm ( = 7769) incurred 22% higher mean total all-cause medical and pharmaceutical spending than unaffected matched controls ( = 41,308) during the first year following childbirth ($36,049 versus $29,448,  < 0.01) and an average of 16 more outpatient visits than unaffected households ( < .01). Costs accrued by mothers comprised the largest share (>50%) of total all-cause spending. Mothers identified with PPD had significantly higher annual mean direct total all-cause medical and pharmaceutical spending than their matched controls without PPD ($19,611 versus $15,410,  < .01), driven primarily by an average of 11 more outpatient visits than unaffected mothers ( < .01).

CONCLUSIONS

Households affected by PPD as identified by the algorithm incurred higher mean total all-cause medical and pharmaceutical spending during the first year following childbirth than did their matched controls identified without PPD, but not all costs were attributable to maternal treatment for PPD. These findings contribute to a better understanding of the potential economic burden associated with PPD and demonstrated costs may extend beyond the mother to members of the household.

摘要

目的

量化产后抑郁症(PPD)给产后投保家庭带来的经济负担。

方法

使用 OptumHealth Care Solutions 的管理索赔数据(2009-2016 年),确定符合算法中 PPD 诊断标准的家庭,并将其与未被诊断为 PPD 或产后抑郁史的女性的倾向评分匹配对照组家庭进行比较。研究结果包括产后第一年的直接总医疗和药物总成本以及按家庭成员分层的家庭层面的门诊就诊次数。

结果

算法确定的受 PPD 影响的家庭( = 7769)在产后第一年的总医疗和药物支出比未受影响的匹配对照组家庭高 22%( = 41308)($36049 与 $29448, < 0.01),且平均门诊就诊次数比未受影响的家庭多 16 次( < 0.01)。母亲的费用占总医疗支出的最大份额(>50%)。被诊断为 PPD 的母亲的年平均直接总医疗和药物支出明显高于未患 PPD 的匹配对照组母亲($19611 与 $15410, < 0.01),主要是因为与未受影响的母亲相比,平均门诊就诊次数多了 11 次( < 0.01)。

结论

算法确定的受 PPD 影响的家庭在产后第一年的总医疗和药物支出高于未患 PPD 的匹配对照组家庭,但并非所有费用都归因于母亲的 PPD 治疗。这些发现有助于更好地了解与 PPD 相关的潜在经济负担,并表明相关成本可能不仅限于母亲,还可能延伸至家庭其他成员。

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