Mo1376 Depression and the Cost of Outpatient Treatment of Crohn's Disease in an US Academic Medical Center

Abstract

Background: There are over 700,000 Americans affected by Crohn's disease (CD). A number of previous studies have looked at the cost of treating CD but they have focused primarily on inpatient costs. This study examines the cost of CD treatment in an outpatient setting and the economic burden of the comorbidity of depression among CD patients at a US academic medical center. Method: This is a retrospective study examining hospital cost data of all new patients with CD based on ICD-9 coding seen in an academic medical center's Inflammatory Bowel Disease Center from November 2010-November 2011. Chart review confirmed that billing was only for CDrelated issues. Cost data represent the actual cost to the institution of providing the service and was obtained from the institution's cost accounting database. The presence of depression was measured with the Patient Health Questionnaire-9 (PHQ-9), a self-report instrument used as part of the regular clinical practice in the Inflammatory Bowel Disease (IBD) Center. Multiple regression analysis was used to examine the relationship between patient's PHQ-9 score and cost, adjusting for age, race, and gender, as well as an interaction between gender and severity of depression. Results: 650 patients (377 female [58%]) were included in the study. The average age of the patients is 39.7 years [(malesM.39.4 (SD. 15.85) femalesM39.9,( SD. 15.85)]. The average PHQ9 score is 6.80. Females had a higher average PHQ-9 score of 7.80 (SD. 6.40 ) vs. males-