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Peter Alsaloum, Chandruganesh Rasendran, Yahya Imran, Rishi P Singh, Katherine Talcott; Incremental Economic Burden of Depression in Ophthalmic Patients. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2650.
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The total economic burden of ophthalmic pathologies is rising exponentially. In addition, there is a correlation between the development of depression in patients with vision problems; yet, little is known about the additional economic stress of depression placed on these co-morbid patients. A retrospective cross-sectional analysis was performed to analyze the incremental economic burden of depression on adults with ophthalmic conditions in the United States.
Adults with at least one outpatient ophthalmology visit were identified by ICD-9-CM codes within the Medical Expenditure Panel Survey (MEPS, 2007-2015). These patients were stratified based on the presence of concurrent depression. A multivariate two-part regression model was used to compare economic burden, healthcare utilization, and expenditures between ophthalmic patients with and without depression.
Ophthalmic patients diagnosed with depression (n=2474) had a mean expenditure of $15,385.48±731.38 while ophthalmic patients without depression (n=7944) had a mean expenditure of $11,744.26±350.98. Patients with depression were more likely to be female, white, and lower-income (p<0.001). These patients faced $2,564.25 (p<0.001) in incremental economic expenditures due to depression, resulting in an additional $4.52 billion annually when extrapolating nationally. These patients also had higher expenditures for inpatient (p=0.002) and prescription medications (p<0.001) (Table 1).
The increase in inpatient and medication expenditures were the major drivers of high healthcare utilization seen in ophthalmic patients with depression. However, there was no difference in outpatient expenditures, suggesting possible inadequate outpatient management of depression in these patients with increased reliance on inpatient care. Alternatively, these patients may have confounding systemic diseases that require inpatient hospitalization and eye-related exams. The presence of a bidirectional relationship between ophthalmic and psychiatric conditions and the demonstrated financial burden for patients with both, displays the need for ophthalmologists to be more cognizant of the financial burdens of depression among their patients.
This is a 2021 ARVO Annual Meeting abstract.
Table 1: Odds ratio comparing healthcare utilization and expenditures between ophthalmic patients with and without depression, adjusting for sociodemographic characteristics and comorbidities.
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