Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Differential impact of mental health multimorbidity on healthcare costs in diabetes.

Egede LE, Gebregziabher M, Zhao Y, Dismuke CE, Walker RJ, Hunt KJ, Axon RN. Differential impact of mental health multimorbidity on healthcare costs in diabetes. The American journal of managed care. 2015 Aug 1; 21(8):535-44.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

OBJECTIVES: This study assessed the prevalence and specific costs associated with discrete multimorbid mental health disease clusters in adults with diabetes mellitus (DM). STUDY DESIGN: Longitudinal analysis of a retrospective cohort. METHODS: We performed a 5-year longitudinal analysis of a retrospective cohort of 733,071 patients with DM from the US Veterans Health Administration (VHA) between 2002 and 2006. The mental health comorbidities (MHCs) examined included depression, substance abuse, and psychosis. Our primary outcomes of interest were total inpatient, outpatient, and pharmacy costs measured in 2012 US$ from the perspective of the VHA. RESULTS: DM was present with comorbid depression, substance abuse, and psychosis in 12.1%, 3.7%, and 4.2% of patients, respectively. Overall, 13.5% of patients had 1 MHC, 2.5% had 2 MHCs, and 0.5% had all MHCs. Total inpatient ($1,435,651,415), outpatient ($366,137,435), and pharmacy ($90,064,725) costs were highest for patients with DM and comorbid depression alone. At the per-patient level, DM plus psychosis and substance abuse had the highest inpatient costs ($35,518), DM plus all MHCs had the highest outpatient costs ($6962), and DM plus depression and psychosis had the highest pharmacy costs ($1753). CONCLUSIONS: DM with comorbid depression is the most prevalent MHC combination and is associated with the highest total VHA healthcare costs. However, other comorbidity clusters are associated with higher mean per patient costs, and may therefore benefit from more intensive intervention. Analysis of healthcare expenditures by multimorbid disease clusters can be a useful tool for healthcare policy planning.





Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.