Association of Adolescent Depressive Symptoms With Health Care Utilization and Payer-Incurred Expenditures
| Autor: | Elizabeth McCauley, Wayne Katon, Malia Oliver, Jeffrey E. Lindenbaum, Davene R. Wright, Laura P. Richardson, Evette J. Ludman |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Alternative medicine Article 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Health care Ambulatory Care medicine Humans Mass Screening 030212 general & internal medicine Psychiatry Association (psychology) Depression (differential diagnoses) Depression business.industry Health Care Costs Health Services Mental health Integrated care Test (assessment) Hospitalization Pediatrics Perinatology and Child Health Female Health Expenditures Emergency Service Hospital business Adolescent health |
| Zdroj: | Academic Pediatrics. 16:82-89 |
| ISSN: | 1876-2859 |
| DOI: | 10.1016/j.acap.2015.08.013 |
| Popis: | Screening adolescents for depression is recommended by the US Preventive Services Task Force. We sought to evaluate the impact of positive depression screens in an adolescent population on health care utilization and costs from a payer perspective.We conducted depression screening among 13- to 17-year-old adolescents enrolled in a large integrated care system using the 2- and 9-item Patient Health Questionnaires (PHQ). Health care utilization and cost data were obtained from administrative records. Chi-square, Wilcoxon rank sum, and t tests were used to test for statistical differences in outcomes between adolescents on the basis of screening status.Of the 4010 adolescents who completed depression screening, 3707 (92.4%) screened negative (PHQ-22 or PHQ-910), 186 (3.9%) screened positive for mild depression (PHQ-9 10-14), and 95 (2.4%) screened positive for moderate to severe depression (PHQ-9 ≥15). In the 12 months after screening, screen-positive adolescents were more likely than screen-negative adolescents to receive any emergency department visit or inpatient hospitalization, and they had significantly higher utilization of outpatient medical (mean ± SD, 8.3 ± 1.5 vs 3.5 ± 5.1) and mental health (3.8 ± 9.3 vs 0.7 ± 3.5) visits. Total health care system costs for screen-positive adolescents ($5083 ± $10,489) were more than twice as high as those of screen-negative adolescents ($2357 ± $7621).Adolescent depressive symptoms, even when mild, are associated with increased health care utilization and costs. Only a minority of the increased costs is attributable to mental health care. Implementing depression screening and evidence-based mental health services may help to better control health care costs among screen-positive adolescents. |
| Databáze: | OpenAIRE |
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