Table 3.
Effect of diagnosed and undiagnosed depression on HRQoL, work productivity loss, activity impairment, health care resource utilization, and costs, relative to controls, after further adjustment for age and CCI
| Dependent variables | Depression | Adjusted mean ± SE (95% CI) | P-value |
|---|---|---|---|
| MCS | Control | 48.6±0.1 (48.5–48.7) | <0.001 |
| Diagnosed depression | 33.2±0.1 (33.1–33.4) | <0.001 | |
| Undiagnosed depression | 34.5±0.1 (34.4–34.6) | – | |
| PCS | Control | 52.8±0.1 (52.7–52.9) | <0.001 |
| Diagnosed depression | 49.2±0.1 (49.1–49.3) | <0.001 | |
| Undiagnosed depression | 49.5±0.1 (49.4–49.6) | – | |
| Health state utility score | Control | 0.76±0.00 (0.76–0.77) | <0.001 |
| Diagnosed depression | 0.61±0.00 (0.61–0.62) | 0.010 | |
| Undiagnosed depression | 0.62±0.00 (0.61–0.62) | – | |
| Absenteeism | Control | 2.5±0.1 (2.4–2.6) | <0.001 |
| Diagnosed depression | 13.1±0.4 (12.5–13.8) | <0.001 | |
| Undiagnosed depression | 6.6±0.28 (6.3–6.9) | – | |
| Presenteeism | Control | 18.8±0.1 (18.6–19.1) | <0.001 |
| Diagnosed depression | 41.4±0.3 (40.8–42.0) | <0.001 | |
| Undiagnosed depression | 38.1±0.3 (37.5–38.6) | – | |
| Overall work productivity impairment | Control | 20.2±0.2 (19.9–20.5) | <0.001 |
| Diagnosed depression | 47.2±0.4 (46.5–47.9) | <0.001 | |
| Undiagnosed depression | 41.1±0.3 (40.5–41.7) | – | |
| Activity impairment | Control | 21.1±0.1 (20.9–21.3) | <0.001 |
| Diagnosed depression | 48.4±0.3 (47.9–48.9) | <0.001 | |
| Undiagnosed depression | 43.3±0.2 (42.9–43.8) | – | |
| ER visits in the past 6 months | Control | 0.08±0.00 (0.08–0.09) | <0.001 |
| Diagnosed depression | 0.31±0.02 (0.28–0.35) | <0.001 | |
| Undiagnosed depression | 0.22±0.01 (0.20–0.24) | – | |
| Hospitalizations in the past 6 months | Control | 0.4±0.0 (0.4–0.4) | <0.001 |
| Diagnosed depression | 1.6±0.1 (1.5–1.8) | <0.001 | |
| Undiagnosed depression | 1.0±0.1 (0.9–1.1) | – | |
| Health care provider visits in past 6 months | Control | 3.7±0.0 (3.6–3.7) | <0.001 |
| Diagnosed depression | 14.0±0.2 (13.7–14.3) | <0.001 | |
| Undiagnosed depression | 6.1±0.1 (5.9–6.2) | – | |
| APP indirect costs (¥) | Control | 1,010,952±7,692 (995,988–1,026,141) | <0.001 |
| Diagnosed depression | 2,362,715±17,942 (2,327,809–2,398,143) | <0.001 | |
| Undiagnosed depression | 2,059,261±15,773 (2,028,577–2,090,410) | – | |
| APP direct costs (¥) | Control | 499,813±21,410 (459,564–543,587) | <0.001 |
| Diagnosed depression | 2,050,538±85,762 (1,889,152–2,225,710) | <0.001 | |
| Undiagnosed depression | 1,225,569±51,035 (1,129,516–1,329,790) | – | |
| APP hospital costs (¥) | Control | 23,398±1,175 (21,204–25,819) | <0.001 |
| Diagnosed depression | 96,919±4,882 (87,808–106,976) | <0.001 | |
| Undiagnosed depression | 58,454±2,949 (52,951–64,528) | – | |
| APP ER costs (¥) | Control | 5,255±198 (4,880–5,658) | <0.001 |
| Diagnosed depression | 19,279±905 (17,585–21,136) | <0.001 | |
| Undiagnosed depression | 13,663±609 (12,520–14,911) | – | |
| APP physician costs (¥) | Control | 60,447±431 (59,608–61,298) | <0.001 |
| Diagnosed depression | 231,873±1,964 (228,055–235,755) | <0.001 | |
| Undiagnosed depression | 100,252±885 (98,533–102,000) | – |
Abbreviations: APP, annual per-patient; ER, emergency room; HRQoL, health-related quality of life; MCS, Mental Component Summary; PCS, Physical Component Summary; SE, standard error.