Excess Health Care Expenditures Associated with Depression in Individuals with Arthritis and Related Joint Disorders

OBJECTIVE: Estimate the excess healthcare expenditures associated with depression in individuals with arthritis and related joint disorders, after controlling for demographic, socio-economic, access to care and other health status variables. METHODS: Cross-sectional data on 5,247 adults from the nationally representative household survey, Medical Expenditure Panel Survey (MEPS) was used. Arthritis was identified from using Medical conditions file and population characteristics data files. Dependent variables consisted of total, inpatient, outpatient, emergency room, prescription drugs and other expenditures. OLS on logged dollars and generalized linear models with log-link were performed. All analyses accounted for the complex survey design of the MEPS. FINDINGS: Overall, 17.8% of individuals with arthritis reported having depression. Among individuals with arthritis and depression the average healthcare expenditures were $12,312 compared to $7,575 among those without depression. After adjusting for demographic, socio-economic, access to care and other health status variables, those with depression had about 50% greater total expenditures compared to those without depression. Individuals with arthritis and depression were significantly more likely to use emergency care (AOR = 1.44) and had higher emergency room expenditures compared to their counterparts without depression. CONCLUSION: The presence of depression in individuals with arthritis and other joint disorders results in higher healthcare utilization and expenditures compared to those without depression.

IMPLICATION: Policy efforts need to target interventions that may reduce excess healthcare expenditures associated with depression in individuals with arthritis. These efforts may include screening for depressive symptoms, timely depression treatment to reduce emergency room utilization and expenditures.