Antidepressant treatment and health services utilization among HIV-infected Medicaid patients diagnosed with depression

OBJECTIVE: To characterize the prevalence and predictors of diagnosed depre ssion among persons with HIV an Medicaid and antidepressant treatment among those diagnosed, and to compare utilization and costs between depressed HI V-infected individuals treated with and without antidepressant medications. DESIGN: Merged Medicaid and surveillance data were used to compare health s ervices utilized by depressed individuals who were or were not treated with antidepressant medications, controlling for other characteristics. SETTING AND PARTICIPANTS: The study population comprised Medicaid recipient s in New Jersey who were diagnosed with HIV or AIDS by March 1996 and recei ved Medicaid services between 1991 and 1996. MEASUREMENTS AND MAIN RESULTS: Logistic regression and ordinary least squar es regressions were employed. Women were more likely and African Americans were less likely to be diagnosed with depression. Women and drug users in t reatment were more likely to receive antidepressant treatment. Depressed pa tients treated with antidepressants were more likely to receive antiretrovi ral treatment than those not treated with antidepressants. Monthly total ex penditures were significantly lower for individuals diagnosed with depressi on and receiving antidepressant therapy than for those not treated with ant idepressants. After controlling for socioeconomic and clinical characterist ics, treatment with antidepressant medications was associated with a 24% re duction in monthly total health care costs. CONCLUSIONS: Depressed HIV-infected patients treated with antidepressants w ere more likely than untreated subjects to receive appropriate care for the ir HIV disease. Antidepressant therapy for treatment of depression is assoc iated with a significantly lower monthly cost of medical care services.