35025 Incremental financial burden and health care services associated with depression in dermatology patients

Abstract

While the prevalence of depression grows among patients with dermatologic disease, there are limited data on its incremental economic burden. The objective of this retrospective cross-sectional study is to quantify the cost of depression in patients with concurrent dermatologic conditions. Using the Medical Expenditure Panel Survey (MEPS) from January 1, 2016, through December 31, 2018, patients with dermatologic conditions and at least 1 outpatient visit were identified using ICD-10-CM codes and stratified based on the presence or absence of depression. A cross-validated 2-step multivariate regression model was used to determine the incremental system-wide economic burden, health care sector utilization, and expenditures associated with depression in this patient cohort. Of the 10122 dermatology patients included, 1593 (15.74%) were diagnosed with depression (mean expenditures: 16,327.45 ± 1640.86) and 8529 patients (84.26%) without depression (mean expenditures: 10,222.83 ± 519.01). Patients with depression were more likely to be female (71%), white (72%), lower income (40.8%), use Medicare or Medicaid (42%), and have comorbidities (P < .001 for all). In these patients, healthcare expenditure was 1.44-fold higher and incurred an additional $4988.94 attributed to depression (95% CI, $3471.19 – $6248.78, P < .001), resulting in a system-wide annual cost of $26.7 billion. These patients required more inpatient visits (OR 1.19, P = .042), medication visits (OR 1.62, P < .001) and were more likely to visit the emergency room (OR 1.37, P < .001). As the prevalence of depression in dermatology grows, dermatologists need to be more cognizant of its economic impact and develop strategies to identify and manage depression.