Depression in elderly may raise health care costs
Depressive symptoms in the elderly are associated with a significant increase in the cost of medical services, according to an article in the Journal of the American Medical Association.Jurgen Unutzer, MD, MPH, from the University of Washington in Seattle, and colleagues followed 2,558 Medicare patients who enrolled in a four-year study. All were over the age of 65, and were receiving care at outpatient clinics of the Group Health Cooperative of Puget Sound (GHC), a large HMO serving about 400,000 people in western Washington State.
Depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale (CES-D), a 20-item self-rating scale developed to screen for probable depressive disorders in primary care settings. The researchers used a score of 16 or higher on the CES-D to define significant depressive symptoms.
They found that 14% of the patients had CES-D scores of 16 or greater when the study began. The number increased to 16% at the two-year follow-up, and 18% at the four-year follow-up. Some patients had depressive symptoms that appeared to persist for two or even four years.
"Patients with significant depressive symptoms at baseline had higher median costs during the first year after the baseline survey ($2,147) than patients without depressive symptoms ($1,461)," the researchers say. "They also had higher median costs for the four-year period after the baseline survey ($15,423 vs. $10,152)."
While acknowledging they cannot conclude that better treatment of depression among the elderly would reduce total health care costs, the researchers say it may be more cost-effective. "It would produce more improvement in health and well-being for each dollar spent in the care of these older adults."
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