title: Depression increases stroke hospitalization cost: an analysis of 17,010 stroke patients in 2008 by race and gender.
abstract: Objective. This analysis focuses on the effect of depression on the cost of hospitalization of stroke patients. Methods. Data on 17,010 stroke patients (primary diagnosis) were extracted from 2008 Tennessee Hospital Discharge Data System. Three groups of patients were compared: (1) stroke only (S(O), n = 7,850), (2) stroke + depression (S(+D), n = 3,965), and (3) stroke + other mental health diagnoses (S(+M), n = 5,195). Results. Of all adult patients, 4.3% were diagnosed with stroke. Stroke was more prevalent among blacks than whites (4.5% versus 4.2%, P < 0.001) and among males than females (5.1% versus 3.7%, P < 0.001). Nearly one-quarter of stroke patients (23.3%) were diagnosed with depression/anxiety. Hospital stroke cost was higher among depressed stroke patients (S(+D)) compared to stroke only (S(O)) patients ($77,864 versus $47,790, P < 0.001), and among S(+D), cost was higher for black males compared to white depressed males ($97,196 versus $88,115, P < 0.001). Similar racial trends in cost emerged among S(+D) females. Conclusion. Depression in stroke patients is associated with increased hospitalization costs. Higher stroke cost among blacks may reflect the impact of comorbidities and the delay in care of serious health conditions. Attention to early detection of depression in stroke patients might reduce inpatient healthcare costs.
authors.affiliation: Tennessee State University, Nashville, TN 37209, USA.
authors.forename: Baqar
authors.initials: B
authors.lastname: Husaini
authors.forename: Robert
authors.initials: R
authors.lastname: Levine
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
authors.forename: Van
authors.initials: V
authors.lastname: Cain
authors.forename: Meggan
authors.initials: M
authors.lastname: Novotny
authors.forename: Pamela
authors.initials: P
authors.lastname: Hull
authors.forename: Gail
authors.initials: G
authors.lastname: Orum
authors.forename: Zahid
authors.initials: Z
authors.lastname: Samad
authors.forename: Uchechukwu
authors.initials: U
authors.lastname: Sampson
authors.forename: Majaz
authors.initials: M
authors.lastname: Moonis
references.citation: Vasc Health Risk Manag. 2010 Oct 05;6:905-13
references.pmid: 20957133
references.citation: Stroke. 2005 Jan;36(1):98-102
references.pmid: 15569872
references.citation: Stroke. 1996 Feb;27(2):270-5
references.pmid: 8571422
references.citation: J Med Assoc Thai. 2008 Oct;91(10):1595-602
references.pmid: 18972905
references.citation: Disabil Rehabil. 2008;30(24):1858-66
references.pmid: 19037779
references.citation: Depress Anxiety. 2005;21(4):178-84
references.pmid: 16075454
references.citation: J Fam Pract. 2000 Feb;49(2):147-52
references.pmid: 10718692
references.citation: Arch Clin Neuropsychol. 2007 May;22(4):519-31
references.pmid: 17462857
references.citation: Vital Health Stat 13. 2001 Jul;(149):1-46
references.pmid: 11478128
references.citation: JAMA. 1997 May 28;277(20):1618-23
references.pmid: 9168292
references.citation: Psychol Med. 2013 Jul;43(7):1423-31
references.pmid: 23114010
references.citation: Cerebrovasc Dis. 2009;27(4):353-60
references.pmid: 19218801
references.citation: Stroke. 2012 Jan;43(1):32-7
references.pmid: 22020036
references.citation: Farm Hosp. 2008 Nov-Dec;32(6):309-14
references.pmid: 19232215
references.citation: Neurology. 2004 Mar 23;62(6):905-11
references.pmid: 15037691
references.citation: Int J Geriatr Psychiatry. 2006 Apr;21(4):382-7
references.pmid: 16534769
references.citation: Am Heart J. 2011 Jun;161(6):1186-1191.e1
references.pmid: 21641367
references.citation: Disabil Rehabil. 2011;33(7):539-56
references.pmid: 20690858
references.citation: Home Health Care Serv Q. 2001;19(3):35-44
references.pmid: 11436405
references.citation: Stroke. 2011 Jun;42(6):1697-701
references.pmid: 21546471
references.citation: Am J Manag Care. 2010 Mar;16(3):e86-e93
references.pmid: 20205493
references.citation: Psychosomatics. 2009 Nov-Dec;50(6):563-9
references.pmid: 19996226
references.citation: Psychiatr Serv. 2011 Oct;62(10):1167-79
references.pmid: 21969643
references.citation: Disabil Rehabil. 2007 Mar 15;29(5):353-8
references.pmid: 17364786
references.citation: J Affect Disord. 2010 Dec;127(1-3):211-8
references.pmid: 20933286
references.citation: Int J Geriatr Psychiatry. 2010 Mar;25(3):298-304
references.pmid: 19637399
references.citation: Stroke. 2010 Sep;41(9):1896-900
references.pmid: 20671256
references.citation: Br J Psychiatry. 1995 Mar;166(3):320-7
references.pmid: 7788123
references.citation: Acta Clin Croat. 2009 Sep;48(3):329-33
references.pmid: 20055258
references.citation: Neurol Neurochir Pol. 2010 Jan-Feb;44(1):13-20
references.pmid: 20358481
references.citation: J Psychosom Res. 2010 Jun;68(6):545-51
references.pmid: 20488271
references.citation: J Womens Health (Larchmt). 2012 Feb;21(2):133-9
references.pmid: 21988550
references.citation: Cerebrovasc Dis. 2009;28(6):551-7
references.pmid: 19844094
references.citation: Rev Neurol (Paris). 2008 Oct;164(10):837-40
references.pmid: 18771785
references.citation: West J Nurs Res. 2011 Jun;33(4):522-39
references.pmid: 20966346
references.citation: Gen Hosp Psychiatry. 2010 Jan-Feb;32(1):80-5
references.pmid: 20114132
references.citation: J Nutr Health Aging. 2010 Jun;14(6):488-93
references.pmid: 20617294
references.citation: J Psychosom Res. 2005 Oct;59(4):209-13
references.pmid: 16223623
references.citation: J Nerv Ment Dis. 1996 May;184(5):274-80
references.pmid: 8627272
references.citation: Am J Med Sci. 2007 Jun;333(6):327-32
references.pmid: 17570984
references.citation: J Rehabil Med. 2009 Nov;41(11):930-5
references.pmid: 19841846
references.citation: Am J Geriatr Psychiatry. 2011 Aug;19(8):721-9
references.pmid: 21788922
references.citation: Am J Psychiatry. 2004 Jun;161(6):1090-5
references.pmid: 15169698
references.citation: J Stroke Cerebrovasc Dis. 2010 Sep-Oct;19(5):364-9
references.pmid: 20547073
references.citation: Stroke. 2006 Nov;37(11):2796-801
references.pmid: 17008625
references.citation: J Am Coll Cardiol. 2009 Jan 13;53(2):176-83
references.pmid: 19130986
references.citation: Am J Psychiatry. 2000 Aug;157(8):1337-40
references.pmid: 10910803
references.citation: Stroke. 2011 Jul;42(7):2091-116
references.pmid: 21617147