Depression and race affect hospitalization costs of heart failure patients

Abstract

Objective Depression and anxiety are frequently observed in heart failure (HF) patients; however, the effect of such factors on hospitalization costs of HF patients, and whether such costs vary by race and gender remain poorly understood. This analysis delineated the prevalence of depression/anxiety among HF patients and estimated the effect of race and gender on hospitalization costs. Methods We examined the 2008 files of the Tennessee Hospital Discharge Data System (HDDS) on patients (≥20 years of age) with a primary diagnosis of HF (ICD-9 codes 402, 404, and 428) along with demographic data, depression/anxiety diagnoses, hospital costs, and comorbidities. Among the HF sample (n=16,889) 53% were female and 23% were black. Race and gender differences in hospital costs were evaluated for the following three groups: (1) HF patients with depression/anxiety (HF+D); (2) HF-only patients without depression/anxiety (HFO); and (3) HF patients with other mental diagnoses (HF+M). Results HF was significantly (p Conclusion Race and depression/anxiety are associated with increased hospitalization costs of HF patients. The higher costs among blacks reflect the higher burden of comorbidities, such as hypertension and diabetes, which calls for widespread dissemination, adoption, and implementation of proven interventions for the control of these comorbidities.