Id 730 Use Of Services And Health Care Costs Of Mental Disorders In Primary Care

Conference: 
Author(s): 
Serrano Blanco A, Fernández Sánchez A, McCrone P, Sabes Figuera R, Knapp M, and DASMAP Group
Spain
aserrano@pssjd.org
Text: 
Aim(s) or purpose: Evaluate the use of services and health care costs of mental disorders (MD) in Primary Care (PC) and to evaluate the factors associated to higher costs.
Design and method: A face-to-face cross-sectional survey of a representative sample of adult consultants to PC health centres from Catalonia was conducted between 2005 and 2006 (DASMAP study). A total of 3,815 participants from 77 health centres were evaluated. A bottom-up prevalence-based costing approach was applied for estimating total costs, using a societal perspective. Number of primary care visits, psychotropic drugs prescribed in the past 12 months, and diagnosing tests were obtained from the clinical chart. Other data was assessed using the Spanish version of the Client Socio-Demographic and Service Receipt Inventory. Unit cost data was provided by the Catalan Minister of Health.
Results: The mean number of general practitioner (GP) consultations was 8.55 visits. After controlling for the confounding effect of socio-demographic and other clinical variables, the presence of any MD was associated to a higher number of GP consultations. By MD, mood disorders (B coefficient = 1.38; 95 %CI 0.51-2.26) and anxiety disorders (B coefficient = 0.71; 95 %CI 0.14-1.29) were associated to increase the number of GP consultations. The mean total costs were 2076.76€ (95 %CI 1900.37-2253.16). Those with MD has a mean total cost of 3097.58€ (95 %CI 1900.37-2253.16), and those without MD of 1640.10€ (95 %CI 1455.96-1824.23). Indirect costs were 55 % of the total in those without MD, and 70 % in those with any MD. Mood disorders were associated to increase both total costs (B = 76.11; 95 %CI 9.21-43.01) and direct costs (B = 102.99; 95 %CI 35.20- 170.78). Among the chronic medical illness, pain, respiratory illness, cardiovascular diseases and hypertension were also associated to increase costs, both total and direct.
Conclusions: Mental disorders are highly prevalent in PC; generate high use of services and elevated health care costs. Mood disorders are those with higher costs.
Literature: 
ID 730
Use of services and health care costs of mental disorders in primary care