EXPENDITURES FOR THE TREATMENT OF MAJOR DEPRESSION

Objective: Health policy makers lack accurate information about per ca pita spending for the treatment of major depression, the distribution of those expenditures, and the proportion of the health cave dollar co nsumed by depression treatment. Method: The authors recruited and foll owed a community cohort of individuals with major depression; the 298 subjects were either enrolled in fee-for-service insurance plans or se lf-insured. Charges for all health care services received during the y ear following baseline were abstracted from medical and insurance reco rds. Results: Over the course of year, 48.1% of the subjects received depression treatment. The per capita total expenditure for inpatient a nd outpatient depression treatment averaged $631, with a median of $15 2, for the treated subjects. Just 4.9% of the treated subjects consume d 45.0% of the outpatient expenditures. Depression treatment consumed only 8 cents of every health care dollar spent on the patients treated for depression. Conclusions: Studies are needed to examine how the le vel and distribution of expenditures for depression treatment change u nder managed cave and to determine whether and how any differences aff ect outcomes in the afflicted population. Managed care attempts to con tain costs by limiting outpatient care may not affect total health car e expenditures dramatically, since depression treatment consumes such a minuscule portion of the health care dollar spent on this population .