Direct costs associated with depressive symptoms in late life: a 4.5-year prospective study.
BACKGROUND
Depression in old age is common. Only few studies examined the association of depressive symptoms and direct costs in the elderly in a cross-sectional way. This study aims to investigate prospectively health service use and direct costs over a course of 4.5 years considering also different courses of depressive symptomatology.


METHODS
305 primary care patients aged 75+ were assessed face-to-face regarding depressive symptoms (Geriatric Depression Scale), and service use and costs at baseline and 4.5 years later. Resource utilization was monetarily valued using 2004/2005 prices. The association of baseline factors and direct costs after 4.5 years was analyzed by multivariate linear regression.


RESULTS
Mean annual direct costs of depressed individuals at baseline and follow-up were almost one-third higher than of non-depressed, and highest for individuals with chronic depressive symptoms. Most relevant cost drivers were costs for inpatient care, pharmaceuticals, and home care. Costs for home care increased at most in individuals with chronic depressive symptoms. Baseline variables that were associated with direct costs after 4.5 years were number of medications as a measure of comorbidity, age, gender, and depressive symptoms.


CONCLUSIONS
Presence and persistence of depressive symptoms in old age seems to be associated with future direct costs even after adjustment for comorbidity. The findings deign a look to the potential economic consequences of depressive symptoms in the elderly for the healthcare system in the future.
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. Melanie.Luppa@medizin.unileipzig.de
Melanie
M
Luppa
Hans-Helmut
HH
König
Dirk
D
Heider
Hanna
H
Leicht
Tom
T
Motzek
Georg
G
Schomerus
Steffi G
SG
Riedel-Heller
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000191:economics* / Q000627:therapeutic use; D003710:Demography; D003863:Depression / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006699:Home Care Services / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors
D000928:Antidepressive Agents