Health care costs of depression in patients diagnosed with cancer.

Abstract

Depression is common among patients diagnosed with cancer. Patients with cancer and depression use more health care services compared with nondepressed cancer patients. The current study seeks to estimate the added cost of depression in cancer patients in the first year after cancer diagnosis. Health care charges were obtained for 2051 depressed and 11182 nondepressed patients with an International Classification of Diseases, Ninth Revision, diagnosis of cancer in the 2014 calendar year from the University of California San Diego Healthcare System. The annual health care charges for cancer patients with and without depression were analyzed using generalized linear models with a log-link function and gamma distribution, covarying for age, sex, race/ethnicity, comorbid diseases, and presence of metastatic disease. Total cost data were broken down into several categories including ambulatory care, emergency department visits, and hospital visits. Depressed cancer patients had total annual health care charges that were 113% higher than nondepressed cancer patients (B=0.76; P<.001). The estimated mean charges for depressed patients were $235337 compared with $110650 for nondepressed patients. Depressed cancer patients incurred greater charges than nondepressed patients in ambulatory care (B=0.70; P<.001), emergency department charges (B=0.31; P<.001), and hospital charges (B=0.39; P<.001). Depressed cancer patients incur significantly higher health care charges across multiple cost categories including ambulatory care, emergency department visits, and hospital visits. Future research should investigate if interventions for detecting and treating depression are effective for reducing health care use and costs in cancer patients.