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共病抑郁症和2型糖尿病的负担:一项使用商业保险数据的实证研究。

The Burden of Comorbid Depression and Type 2 Diabetes: An Empirical Study Using Commercial Insurance Data.

作者信息

Ahn SangNam, Han Gang, Beck McKenzie, Hsu Wan-Ling, Towne Samuel D, Smith Matthew Lee, Ory Marcia G

机构信息

Saint Louis University College for Public Health and Social Justice Department of Health Policy and Management, Saint Louis, MO, USA.

Texas A&M University School of Public Health Center for Health and Aging, College Station, TX, USA.

出版信息

J Prim Care Community Health. 2025 Jan-Dec;16:21501319251336629. doi: 10.1177/21501319251336629. Epub 2025 May 8.

Abstract

INTRODUCTION

Despite rising rates of depression and diabetes, assessments of depression's burden on diabetes management and its economic burden remain limited. In this study, we evaluate the burden of depression on diabetes management and quantify the financial implications of comorbid depression and diabetes.

METHODS

We performed propensity score matching on Texas commercial claims data (2016-2019) to match type 2 diabetes patients with depression (n = 613) to those without (n = 583). Depression flagged in 2016/2017 indicated initial depression, and an A1C level of ≥8% in 2018/2019 indicated follow-up uncontrolled diabetes. Healthcare costs included total, diabetes-related, outpatient, and inpatient costs incurred during 2018/2019.

RESULTS

A depression flag in the initial period was linked to a 2.7 percentage point increase ( = .031) in the probability of having an A1C level of ≥8% in the follow-up, compared to individuals without a depression flag. Having both a depression flag and uncontrolled A1C in the initial period was associated with $2,037 higher total medical costs ( = .004), $494 higher diabetes-related costs ( = .020), and $336 higher outpatient costs ( = .008) in the follow-up, compared to the respective averages of $6,900, $474, and $583 for individuals without a depression flag or uncontrolled A1C.

CONCLUSIONS

Our findings highlight the detrimental effect of depression on uncontrolled diabetes and the subsequent increase in healthcare costs. Further research is warranted to determine the effectiveness of proactive treatments for depression in managing diabetes, improving glycemic control, and reducing healthcare costs.

摘要

引言

尽管抑郁症和糖尿病的发病率不断上升,但关于抑郁症对糖尿病管理的负担及其经济负担的评估仍然有限。在本研究中,我们评估了抑郁症对糖尿病管理的负担,并量化了抑郁症与糖尿病共病的财务影响。

方法

我们对德克萨斯州商业索赔数据(2016 - 2019年)进行倾向得分匹配,以将患有抑郁症的2型糖尿病患者(n = 613)与未患抑郁症的患者(n = 583)进行匹配。2016/2017年标记的抑郁症表明为初始抑郁症,2018/2019年糖化血红蛋白(A1C)水平≥8%表明随访时糖尿病未得到控制。医疗保健成本包括2018/2019年期间产生的总费用、与糖尿病相关的费用、门诊费用和住院费用。

结果

与没有抑郁症标记的个体相比,初始阶段有抑郁症标记与随访时糖化血红蛋白水平≥8%的概率增加2.7个百分点(P = 0.031)相关。与没有抑郁症标记或糖化血红蛋白未得到控制的个体各自平均费用6900美元、474美元和583美元相比,初始阶段既有抑郁症标记又有未得到控制的糖化血红蛋白水平与随访时总医疗费用高出2037美元(P = 0.004)、与糖尿病相关的费用高出494美元(P = 0.020)以及门诊费用高出336美元(P = 0.008)相关。

结论

我们的研究结果突出了抑郁症对未得到控制的糖尿病的有害影响以及随后医疗保健成本的增加。有必要进行进一步研究以确定抑郁症的积极治疗在管理糖尿病、改善血糖控制和降低医疗保健成本方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/792f/12062637/73f3b15de9e0/10.1177_21501319251336629-fig1.jpg

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