Health and disability costs of depressive illness in a major U.S. corporation.
OBJECTIVE
Employers are playing an increasingly influential role in determining the scope and character of health coverage in the United States. This study compares the health and disability costs of depressive illness with those of four other chronic conditions among employees of a large U.S. corporation.


METHODS
Data from the health and employee files of 15,153 employees of a major U.S. corporation who filed health claims in 1995 were examined. Analyses compared the mental health costs, medical costs, sick days, and total health and disability costs associated with depression and four other conditions: heart disease, diabetes, hypertension, and back problems. Regression models were used to control for demographic differences and job characteristics.


RESULTS
Employees treated for depression incurred annual per capita health and disability costs of $5,415, significantly more than the cost for hypertension and comparable to the cost for the three other medical conditions. Employees with depressive illness plus any of the other conditions cost 1.7 times more than those with the comparison medical conditions alone. Depressive illness was associated with a mean of 9.86 annual sick days, significantly more than any of the other conditions. Depressed employees under the age of 40 years took 3.5 more annual sick days than those 40 years old or older.


CONCLUSIONS
The cost of depression to employers, particularly the cost in lost work days, is as great or greater than the cost of many other common medical illnesses, and the combination of depressive and other common illnesses is particularly costly. The strong association between depressive illness and sick days in younger workers suggests that the impact of depression may increase as these workers age.
Department of Psychiatry, Yale University, West Haven, CT 06516, USA. benjamin.druss@yale.edu
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Druss
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Rosenheck
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Sledge
D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000191:economics; D002908:Chronic Disease; D015897:Comorbidity; D017281:Cost of Illness; D003866:Depressive Disorder / Q000191:economics* / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000191:economics; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics* / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006331:Heart Diseases / Q000191:economics; D006801:Humans; D006973:Hypertension / Q000191:economics; D018868:Insurance, Disability / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data