PMU63 EXPLORING THE SYMPTOMATOLOGY OF DEPRESSION AND ITS EFFECT ON HEALTHCARE EXPENDITURES AND QUALITY OF LIFE OF DIABETIC PATIENTS

Abstract

Depressive symptoms can affect a person's well-being and their ability to self-manage their health condition. The co-existence of depression and diabetes can lead to higher healthcare expenditures and poor health-related quality of life. In this study, we investigated the impact of varying depression symptomatology on total healthcare expenditures and the quality of life of diabetic patients. The 2016 Medical Expenditure Panel Survey (MEPS) data were used to investigate the healthcare expenditures among diabetic adults (aged ≥18 years). A linear regression model was used to elucidate the impact of depression on log-transformed healthcare expenditures. The diabetic patients were stratified into four categories: 1) Diabetes and symptomatic depression 2) Diabetes and asymptomatic depression 3) Diabetes and unrecognized depression 4) Diabetes only, identified using ICD-10-CM code of depression (ICD10= ‘F32’) and patient responses to the PHQ-2 questionnaire. Other independent variables included were predisposing, enabling, need, healthcare environment and personal health practice factors, which influence the healthcare expenditures. Descriptive statistics were used to describe the sample characteristics. Of the 2357 adults with diabetes, 8.32% (n=196) had unrecognized depression, 11.50% (n=271) had asymptomatic depression, and 6.02% (n=142) had symptomatic depression. Diabetic patients with asymptomatic depression had a 90% increase, whereas patients with unrecognized depression had a 14.7% decrease in healthcare expenditures in comparison to the diabetes only group. The mean MCS and PCS scores were significantly higher in the group with asymptomatic depression (MCS=46.79±9.5, PCS=39.47±11.77) and lower in individuals with unrecognized depression (MCS=37.13±11.05, PCS=33.20±11.59). Lower expenditures and MCS/PCS scores in the unrecognized depressed patients may reflect the lack of access to mental healthcare services for clinical diagnosis and treatments. Additional efforts should be explored to identify unrecognized depression in diabetic patients which may minimize the associated burden.