Abstract
Perinatal depression is common, and the rate of depression diagnosis recorded at delivery has been increasing. Depression has been associated with increased length of stay (LOS) and hospital costs in patients with other comorbid conditions. Our objective is to assess delivery LOS and hospital costs in women with depression. We performed a retrospective cohort study using the National Inpatient Sample comparing delivery hospitalizations of women with and without a history of depression in 2012-2016. Ectopic pregnancies, spontaneous and elective abortions were excluded. International Classification of Disease 9th and 10th edition diagnosis and procedure codes were used to identify our cohort and outcomes. The primary outcomes were maternal LOS and total cost of delivery hospitalization. Secondary outcomes included maternal comorbidities, delivery morbidities, and hospital characteristics. Univariate analyses were performed for all primary and secondary outcomes, and multivariate regression was performed for LOS, non-home discharge, and total cost of delivery hospitalization, controlling for confounding variables. 3,531,288 admissions met inclusion criteria, 50,865 (1.4%) of whom had documented depression. There was no significant difference in LOS in women with depression (p=0.16). Women with depression had a higher total hospital cost ($4,194 (2,986-6,042) vs $3,810 (2,731 – 5,413), p<0.001), and were more likely to have a non-home discharge (p<0.001) compared to women without depression. In multivariate regression, depression was associated with increased risk of LOS >3 days (aOR 1.04/95% CI 1.04-1.04), non-home discharge (aOR 1.78/95% CI 1.69-1.88), and total hospital cost >$4,000 (aOR 1.04/95% CI 1.03-1.05). After controlling for pre-existing conditions, mode of delivery, and hospital characteristics, depression was associated with statistically significantly increased length of hospital stay, non-home discharge, and greater total hospital costs, though these differences were small and not likely clinically significant.View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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