The effect of severity of depressive disorder on economic burden in a university hospital in Singapore

Abstract

Background: Depressive disorder is treatable but costly, thus influencing quality of life of people. Aim: Determine direct and indirect costs incurred by depressive disorder in Singapore. Methods: A 1-year prospective naturalistic study was conducted in a university mood disorder center between 2007 and 2008. Patients with primary International Classification of Disease–10 diagnosis of depressive disorder were recruited. Disease costs between mild, moderate and severe depression, and cost predictors were analyzed and determined. Results: Forty nine patients completed the study. Mean annual total costs per patient were US$7638. Indirect costs (81%) dominated the total costs. Approximately 50% of indirect costs were associated with loss of productivity and unemployment. Higher education level, higher mean Hamilton Rating Scale for Depression score and number of suicide attempts were independent variables associated with increased direct costs while mean Hamilton Rating Scale for Depression scale score was an independent variable for indirect costs. Conclusion: Medical cost saving strategies should focus on indirect costs.