Back to Annual Meeting

Back to Annual Meeting

Abstract #158639

• Slides (pdf) or Handout

Patricia M. McGovern, PhD, MPH¹, Rada Dagher, PhD, MPH², Bryan Dowd, PhD³, Donna McAlpine, PhD⁴, Laurie Ukestad, MS⁵, and David McCaffrey, BA¹. (1) Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Mayo Mail Code 807, 420 Delaware St. SE, Minneapolis, MN 55455, (2) Department of Health Services Research, Management and Policy, University of Florida, 101 S. Newell Drive, Room 4144, Gainesville, FL 32611, 3522736066, radadagher@yahoo.com, (3) Division of Health Management and Policy, University of Minnesota, School of Public Health, MMC 729 Mayo 8381, 420 Delaware St. SE, Minneapolis, MN 55455, (4) Division of Health Policy and Management, School of Public Health, University of Minnesota, MMC 729 Mayo 8729, 420 Delaware St. SE, Mineapolis, MN MN, (5) Division of Epidemiology, School of Public Health, University of Minnesota, Room 300 WBOB 7525, 1300 S 2nd St, Minneapolis, MN 55454

Background/Significance: Postpartum depression is a debilitating mental disorder that may increase health services expenditures, but few studies have examined this relationship. Employed postpartum women constitute a vulnerable group due to exposure to job stressors.

Objective: To investigate the association of postpartum depression with health services expenditures.

Methods: Employed women, 18 years of age and older, were recruited in 2001 from three Minnesota hospitals (N= 817; 71% response rate). 79% were followed up with interviews at 5 and 11 weeks after delivery. Using a hybrid of the household and health production theories, two stage least squares analysis was performed, with the price-weighted sum of health services (hospitalizations, outpatient surgeries, office visits, counseling visits and emergency room care) used from hospital discharge until 11 weeks postpartum as the dependent variable.

Results: The women averaged 30 years, 87% were white and 5% met the depression threshold (Edinburgh Postnatal Depression Scale) at 5 weeks postpartum. Depressed women were significantly more likely to utilize emergency room care (18.2%) versus non-depressed women (4.1%) and to seek mental health counseling (22.6% versus 3.8%). In multivariate analyses, variables significantly predicting health services expenditures were: older age, poverty, childbirth complications, acute illnesses and depression. Depressed women incurred 87% more health services expenditures than non-depressed women.

Conclusions: The disproportionate use of counseling and emergency room visits may be driving the increased costs among depressed women. Future research should explore whether earlier identification of depressed women or screening and education in primary care settings may decrease health services use after childbirth.

Learning Objectives: By the end of this session, the learner should be able to

(
• describe which health services depressed women are more likely to utilize during the first 11 weeks after childbirth (
• discuss the possible effects of various demographic and health factors on health services expenditures.

Keywords: Depression, Health Care Utilization

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

• Slides (pdf) or Handout