Abstract

Depression and Cost-Related Health Care Utilization among Persons with Diabetes

Heather McClintock¹, Sarah Edmonds¹, Kate Pashley¹, Hillary Bogner² (1)Arcadia University, (2)University of Pennsylvania

APHA 2022 Annual Meeting and Expo

Background: The presence of depression among persons with diabetes can substantially increase health care costs and reduce healthcare engagement.
Purpose: This study aimed to further elucidate factors underlying the relationship between depressive disorders and health care utilization among persons with diabetes.
Methods: Data was obtained from the 2019 Behavioral Risk Factor Surveillance System and the sample was limited to persons with diabetes. The independent variable was assessed by a lifetime diagnosis of depressive disorder including depression, major depression, dysthymia, or minor depression. The dependent variable was cost-related health care utilization assessed as a response (yes/no) to whether participants had not seen a doctor because of costs in the last year. Logistic regression models examined the association between depressive disorders and health care utilization adjusting for covariates incorporating weighting to account for study design.  
Results: Overall, 25.2% of persons with diabetes reported having had a depressive disorder in their lifetime. Persons with diabetes who had ever had ever been diagnosed with a depressive disorder were more likely to have reported not seeing a doctor due to costs in the past year (adjusted odds ratio: 1.82 (1.49, 2.28)).
Conclusions: Findings from this study suggest a need for further research regarding the relationship between depression and cost-related health care utilization among persons with diabetes. Depression screening, management, and care may be essential to help prevent reduced care utilization among persons with diabetes.