Patients with respiratory conditions who also suffer from depression have much higher health care utilization and costs and require more complex care, according to a new report. The study, published in the journal Pharmacy, offers a glimpse into the ways depression can complicate quality of life and health care for people with respiratory conditions.
The authors explained that respiratory conditions place a significant burden on the US health care system, both in terms of mortality and in terms of health care expenditures. Chronic obstructive pulmonary disease (COPD) is now the fourth-leading cause of death in the United States, and it accounts for about $5 billion in US health care spending each year. Asthma, rates of which have been increasing, accounts for $7 billion in annual spending.
Existing evidence suggests that people who suffer from respiratory diseases, particularly COPD, are more likely to suffer from depression, the authors Prashant Sakharkar, PharmD, of Roosevelt University, and Thanh Mai, a PharmD candidate at Western New England University, wrote, and yet the data also show depression co-occurring with asthma or COPD is often under-treated or untreated.
In order to get a better understanding of links between depression and respiratory diseases, as well as their impact on the wider health care landscape, the authors crafted a study that examined health care utilization and costs of people with respiratory diseases with and without co-occurring depression.
They looked at data from the Medical Expenditure Panel Survey, covering the years 2011-2017, identifying 8,848 patients who had asthma, emphysema, or chronic bronchitis. They found that overall, 1 in 5 patients in the sample (20%) had comorbid depression. They were also more likely to have 2 or fewer chronic conditions, have private insurance, and report significant pain.
In terms of health care utilization, the researchers found individuals with depression and respiratory conditions had more ambulatory-care visits, more prescriptions filled, more emergency department visits, and more hospital inpatient days than their counterparts without depression. That translated to roughly double the total health care expenditures, with people with depression spending an average of $24,532 over the course of the study, and those without spending $12,420.