Costs of inpatient care of depression in 2014 in Polish (Poznan) and German (Kiel) hospital

Economic burden of major depressive disorder: a case study in Southern Iran

BACKGROUND

Depression disorders are a leading cause of disability in the world which imposes a significant economic burden on patients and societies The present study aimed to determine the economic burden of Major Depressive Disorder (MDD) on the patients referred to the reference psychiatric single-specialty hospitals in southern Iran in 2020.

METHODS

This cross-sectional research is a partial economic evaluation and a cost-of-illness study conducted in southern Iran in 2020. A total of 563 patients were enrolled through the census method, and a researcher-made data collection form was used to gather the required information. The prevalence-based and the bottom-up approaches were also used to collect the cost information and calculate the costs, respectively. The data on direct medical, direct non-medical, and indirect costs were obtained using the information in the patients' medical records and insurance bills as well as their self-reports or those of their companions. To calculate the indirect costs, the human capital approach was used as well.

RESULTS

The results showed that the annual cost of MDD was $ 2717.41 Purchasing Power Parity (PPP) (USD 2026.13) per patient in 2020. Direct medical costs accounted for the largest share of the costs (73.68%), of which hoteling and regular beds expenses were the highest (57.70% of the total direct medical costs). The shares of direct non-medical and indirect costs were 7.52 and 18.80%, respectively, and the economic burden of the disease in the country was estimated at $7,120,456,596 PPP (USD 5,309,088,699).

CONCLUSION

In general, due to the high prevalence of MDD and the chronicity of the disease, the costs of its treatment can impose a heavy economic burden on the society, healthcare system, insurance system, and the patients themselves. Therefore, it is suggested that health policymakers and managers should take appropriate measures to increase the basic and supplemental insurance coverage of these patients. In addition, in order to reduce the costs, proper and equitable distribution of psychiatrists and psychiatric beds, expansion of home care services, and use of Internet-based technologies and the cyberspace to follow up the treatment of these patients are recommended.

Cost Analysis for Inpatient Treatment of Recurrent Depressive Disorder in Russia

OBJECTIVES

To estimate costs of pharmacotherapy of recurrent depressive disorder (RDD) in a hospital-based care.

METHODS

In the study, we analyzed the real-world practice in hospital-based care and the costs of RDD pharmacotherapy. A total of 119 case histories of patients who received a diagnosis of RDD and were hospitalized in 2017 were retrospectively analyzed. The study examined sociodemographic data, clinical and economic data, the frequency of prescribing medications, and medical expenses per 1 hospitalization and per day. The sample (N = 119) was divided into 3 groups according to the International Classification of Diseases-10th Revision code and the severity of the disease. The cost conversion factor was 1 euro equals 89.92 rubles.

RESULTS

Antidepressants and antipsychotic drugs prevailed in the structure of prescriptions (32% and 36%, respectively). Antidepressants had the largest share in the total cost structure (about 41%), while the total cost of antidepressants and antipsychotics reached a total of 70%. Less than half of the costs were drugs included in the Russian RDD hospital treatment standard. The most expensive group in terms of pharmacotherapy costs per patient was the group "patients with RDD of moderate severity" (F33.1)-€61.1 ± 92.0 per case of hospitalization; this diagnosis was made in 80% of hospitalized patients.

CONCLUSIONS

Assessment of real-world practices and costs of treatment of patients with RDD allows for more widespread implementation of management methods that allow making a choice in favor of more cost-effective drugs for the treatment of RDDs in Russia.

[Costs of Depression in Germany - Systematic Review]

OBJECTIVE

Depression is a common mental disorder associated with a high economic burden. Aim of this study was to review cost-of-illness studies of depression in Germany.

METHODS

We conducted a systematic literature search of bottom-up cost-of-illness-studies of depression in adults in Germany. Included studies were classified into three groups depending on their costing approach (total health care cost studies, disease-specific health care cost studies, excess cost studies).

RESULTS

Depending on the type of cost calculation the average total costs per patient and year varied between 400-3,300 € for disease-specific costs, 3,000 € for excess costs and 3,000-5,000 € for total health care costs. There were no results for indirect costs in most studies.

CONCLUSION

Depression in Germany is associated with high costs, but especially indirect costs are missing in the current literature and should be examined more intensively.

The Association Between Physical and Mental Health and Face Mask Use During the COVID-19 Pandemic: A Comparison of Two Countries With Different Views and Practices

BACKGROUND

The physical and mental health of citizens living in a country that encouraged face masks (China) and discouraged face masks (Poland) during the initial stage of the COVID-19 pandemic remained unknown. We conducted a cross-country study to compare the psychological impact of the COVID-19 pandemic on Poles and Chinese. This study aimed to compare the levels of psychological impact of pandemic and levels of anxiety and depression between China and Poland.

METHODS

The survey collected information on demographic data, physical symptoms, contact history, and precautionary measures. The psychological impact was assessed using the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). The chi-squared test was used to analyze the differences in categorical variables between the two populations. Linear regression was used to calculate the bivariate associations between independents variables (e.g., physical symptoms and precautionary measures) and dependent variables (e.g., mental health outcomes).

RESULTS

This study included a total of 2,266 respondents from both countries (1,056 Poles and 1,210 Chinese). There were significantly less Polish respondents who wore face masks (Poles: 35.0%; Chinese: 96.8% p < 0.001). Significantly more Polish respondents reported physical symptoms resembling COVID-19 infection (p < 0.001), recent medical consultation (p < 0.01), recent COVID-19 testing (p < 0.001), and hospitalization (p < 0.01). Furthermore, Polish respondents had significantly higher levels of anxiety, depression and stress (p < 0.001) than Chinese. The mean IES-R scores of Poland and China were above the cut-off for post-traumatic stress disorder (PTSD) symptoms. Besides precautionary measures, unemployment, retirement, physical symptoms resembling COVID-19 infection, recent medical consultation or COVID-19 testing, and long daily duration of home confinement were risk factors for PTSD symptoms, anxiety, depression, or stress for Polish respondents.

CONCLUSION

Use of face masks at the community level may safeguard better physical and mental health during the COVID-19 pandemic. There is a need of health education with scientific information from Polish health authority on the proper use of face masks and reduce social stigma. This study was limited by the respondent sampling method that had compromised the representativeness of samples.

Leisure-time physical activity is negatively associated with depression symptoms independently of the socioeconomic status

Objective: There are few studies evaluating the relationship between depression symptoms (DS) and physical activity (PA) considering peoples' sociodemographic characteristics. This study aimed to analyse the relationship between DS and PA, stratified by sociodemographic characteristics of European adults. Methods: Participants were 29,285 adults (13,943 men, 47.6%; 15,342 women, 52.4%), aged 50.9 ± 17.4 (50.6 ± 17.3 men, 51.1 ± 17.5 women) from the European Social Survey round 7. DS was assessed with the Centre for Epidemiological Studies Depression Scale (CES-D8). Leisure-time PA (LTPA) was self-reported. The analysed sociodemographic characteristics were sex, age, living place, household members, marital status, income, and educational level. The relationship between DS and PA, stratified by sociodemographic variables, was examined by linear regression models. Results: Engaging in LTPA was negatively and linearly related to DS, independently of being men or women, being younger, middle or older adult, living in an urban or rural area, having children or not, being single or married, being wealthy or poor, employment status, and to having a lower or a higher education level. Age was the variable with both the least and the greatest effect of LTPA on DS. The least effect of LTPA on DS was observed in younger adults (β = -0.08, 95% CI: -0.11, -0.05) and the greatest effect in retired people (β = -0.33, 95% CI: -0.36, -0.29). Conclusion: Independently of sociodemographic characteristics, LTPA is associated with DS and can benefit everyone. Public health policies for promoting mental health should include PA promotion as an important strategy for the prevention or treatment of DS.