Poor Depression Care After Heart Attack, Stroke Increases Patient Costs

Inadequate management of a patient’s depression following heart attack or stroke is linked with notably higher health care costs, according to a study published online in the Journal of Medical Economics. 

The US-based retrospective study looked at health care resource use and cost data for 1568 patients diagnosed with major depressive disorder after experiencing myocardial infarction or stroke. Researchers assessed antidepressant dose and proportion of days covered by antidepressant medication during the 90-day period after depression diagnosis to determine whether or not a patient received adequate care.

Nearly 60% of patients received inadequate care for major depressive disorder, the study found. 

Compared with patients who received adequate depression care, those with inadequate care had 14% more hospitalizations and 4% more outpatient visits overall. Patients with inadequate depression care had 17% more outpatient visits and 13% more emergency department visits specifically related to cardiovascular disease, researchers reported. 

Per-patient per-year hospitalization costs related to cardiovascular disease were $21,485 for patients with inadequate depression care compared with $17,756 for patients with adequate depression care. Per-patient outpatient costs for cardiovascular disease were $520 annually with inadequate depression care compared with $434 with adequate depression care, according to the study. 

Annual all-cause outpatient costs were also higher with inadequate depression care: $2820 per patient compared with $2055 when depression care was adequate. 

“Among post-myocardial infarction and post-stroke patients, inadequate major depressive disorder care was associated with a significantly higher economic burden,” researchers wrote. 

—Jolynn Tumolo

Reference

Bangalore S, Shah R, Gao X, et al. Economic burden associated with inadequate antidepressant medication management among patients with depression and known cardiovascular diseases: insights from a United States-based retrospective claims database analysis [published online October 21, 2019]. J Med Econ. doi: 10.1080/13696998.2019.1686311