Depression care and relevant cost drivers - a discussion from the German health insurers' point of view

作者：Zerth Juergen^*; Akmaz Buelent L; Domdey Andreas

来源：Psychopharmakotherapie, 2011, 18(1): 27-+.

• Cost-of-illness
• depression
• Germany

Aim: The costs of depression have become a main cost factor for statutory health insurance. In order to identify the main cost drivers form a health insurer's point of view, we want to evaluate different studies that deal with the overall costs for depression.
Methods: A systematic search of cost-of illness studies for depression in medical and economic databases was conducted (bottom-up-approach). We observed data from 2000 to 2008. In order to identify the most relevant cost drivers, we compared studies reporting inpatient, outpatient and pharmaceutical direct costs.
Results: We observed 47 studies. Many of the reviewed papers had to be excluded because they do not match the basic research criteria of a simple meta-analysis. Referring to the included papers, we differentiated between the role of the main cost drivers. Only 4 studies could be considered. Referring to these studies, total direct health care costs deviate between 1,264 E and 2,577 E per year. Pharmaceutical costs per patient are in a range between 9% to 24% of total direct health care costs. Although the comparison of the direct costs varied widely figures show that inpatient care of depression is much more costly than outpatient care.
Conclusion: Costs for depression are fairly driven by inpatient costs. Hence, it is necessary to elaborate the costs in the line of a patient career through longitudinal data analysis. Further research in the optimization of the patient career as well as on an appropriate governance structure between inpatient and outpatient care is necessary.

• 出版日期2011-2