Effect of antidepressant choice on the incidence and economic intensity of hospitalization among depressed individuals.
This study identified differences in hospital utilization for mental health problems among depressed patients initially treated with selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs). A retrospective sample of 2,557 patients was obtained from a private insurance claims database. Quasi-experimental, two-stage multivariate regression modeling was used to estimate the likelihood of hospitalization and subsequent inpatient expenditures. Only 2% of the sample were hospitalized, and the average expenditures per admitted patient was about $8,000. Patients initially prescribed sertraline had the same likelihood of hospitalization for a mental health problem as patients prescribed TCAs. Patients initially prescribed fluoxetine were half as likely to be hospitalized as patients initially prescribed TCAs. Once hospitalized, no differential effects of a specific antidepressant on inpatient expenditures were found.
Health Outcomes Evaluation Group, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA. croghan_thomas_w@lilly.com
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Croghan
T J
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Kniesner
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Melfi
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Robinson
D000293:Adolescent; D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000188:drug therapy* / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D017059:Models, Econometric; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D014600:Utilization Review
D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors