Treatment-resistant depression increases health costs and resource utilization

Revista Brasileira de Psiquiatria

Beatrice Alinka Lepine²  Ricardo Alberto Moreno¹  Rodolfo Nunes Campos¹  Bernard François Couttolenc² 

[1] ,Universidade de São Paulo Faculdade de Saúde Pública ,Brazil

关键词: Depression;    Treatment Resistance;    Resource Utilization;    Treatment Costs;    Hospital Costs;    Depressão;    Resistência ao tratamento;    Utilização de recursos;    Custos de tratamento;    Custos hospitalares;   

DOI  :  10.1016/j.rbp.2012.05.009

来源: SciELO

【 摘 要 】

OBJECTIVE: Major Depressive Disorder (MDD) is a debilitating condition with a marked social impact. The impact of MDD and Treatment-Resistant Depression (TRD+) within the Brazilian health system is largely unknown. The goal of this study was to compare resource utilization and costs of care for treatment-resistant MDD relative to non-treatment-resistant depression (TRD-). METHODS: We retrospectively analyzed the records of 212 patients who had been diagnosed with MDD according to the ICD-10 criteria. Specific criteria were used to identify patients with TRD+. Resource utilization was estimated, and the consumption of medication was annualized. We obtained information on medical visits, procedures, hospitalizations, emergency department visits and medication use related or not to MDD. RESULTS: The sample consisted of 90 TRD+ and 122 TRD- patients. TRD+ patients used significantly more resources from the psychiatric service, but not from non-psychiatric clinics, compared to TRD- patients. Furthermore, TRD+ patients were significantly more likely to require hospitalizations. Overall, TRD+ patients imposed significantly higher (81.5%) annual costs compared to TRD- patients (R$ 5,520.85; US$ 3,075.34 vs. R$ 3,042.14; US$ 1,694.60). These findings demonstrate the burden of MDD, and especially of TRD+ patients, to the tertiary public health system. Our study should raise awareness of the impact of TRD+ and should be considered by policy makers when implementing public mental health initiatives.

【 授权许可】

CC BY-NC   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License