title: COSTS OF DEPRESSION FROM CLAIMS DATA FOR MEDICARE RECIPIENTS IN A POPULATION-BASED SAMPLE.
abstract: BACKGROUND
  Many persons with depressive disorder are not treated and associated costs are not recorded.
  
  
  OBJECTIVE
  To determine whether major depressive disorder (MDD) is associated with higher medical cost among Medicare recipients.
  
  
  METHODS
  Four waves of the Baltimore-Epidemiologic Catchment Area (Baltimore ECA) Study conducted between 1981 and 2004 were linked to Medicare claims data for the years 1999 to 2004 from the Centers for Medicare and Medicaid Services (CMS). Generalized linear models specified with a gamma distribution and log link function were used to examine direct medical care costs associated with MDD.
  
  
  RESULTS
  Medicare recipients with no history of MDD in either the ECA or CMS data had mean six-year medical costs of US $40,670, compared to $87,445 for Medicare recipients with MDD as recorded in CMS data and $43,583 for those with MDD as recorded in Baltimore-ECA data. Multivariable regressions found that compared to Medicare recipients with no history of depression, those with depression identified in the CMS data had significantly higher medical costs; about 1.87 times (95% confidence interval (CI) 1.32 to 2.67) higher. Medicare recipients with a history of depression identified in the ECA data were no more likely to have higher costs than were Medicare recipients with no history of depression (relative ratio 1.33, 95% CI 0.87 to 2.02).
  
  
  CONCLUSIONS
  Medicare recipients with a history of depression identified in claims data had significantly higher medical costs than recipients with no history of depression. However, no significant differences were found between Medicare recipients with depression in the community-based Baltimore ECA data and those with no history of depression. The results show that the source of diagnosis, in treatment versus survey data, produces differences in results as regards costs.
  
  
  CONCLUSIONS
  This study involved only Medicare recipients with claims data over the six years 1999 to 2004. Many of the ECA respondents were too young to qualify for Medicare.
  
  
  CONCLUSIONS
  Depressive disorder involves substantial medical care costs. The findings provide information on the economic burden of depression, an important but often omitted dimension and perspective of the burden of mental illnesses.
authors.forename: Pierre K
authors.initials: PK
authors.lastname: Alexandre
authors.forename: Seungyoung
authors.initials: S
authors.lastname: Hwang
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Roth
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gallo
authors.forename: William W
authors.initials: WW
authors.lastname: Eaton
mesh_terms: D000368:Aged; D015142:Baltimore; D002391:Catchment Area, Health; D003865:Major Depressive Disorder / Q000191:economics* / Q000628:therapy*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D006278:Medicare / Q000191:economics*; D014481:United States