Depression treatment decreases healthcare expenditures among working age patients with comorbid conditions and type 2 diabetes mellitus along with newly-diagnosed depression

Bhattacharya, Rituparna; Shen, Chan; Wachholtz, Amy B.; Dwibedi, Nilanjana; Sambamoorthi, Usha

doi:10.1186/s12888-016-0964-9

Table 1 Description of the study population by coexisting chronic physical condition type among medicaid beneficiaries with type 2 diabetes mellitus and newly diagnosed depression. Multi-state medicaid claims database – 2000–2008

From: Depression treatment decreases healthcare expenditures among working age patients with comorbid conditions and type 2 diabetes mellitus along with newly-diagnosed depression

		All		Dominant		Concordant only		Discordant only		Both concordant & discordant		Sig
		N	%	N	%	N	%	N	%	N	%
All		5295		753	14.2	1444	27.3	834	15.8	2264	42.8	***
Predisposing factors
Age
	18–44	1335	25.2	122	9.1	426	31.9	256	19.2	531	39.8
	45–54	1921	36.3	277	14.4	457	23.8	317	16.5	870	45.3
	55–64	2039	38.5	354	17.4	561	27.5	261	12.8	863	42.3
Sex												***
	Female	3565	67.3	437	12.3	949	26.6	613	17.2	1566	43.9
	Male	1730	32.7	316	18.3	495	28.6	221	12.8	698	40.3
Race												**
	White	1420	26.8	203	14.3	369	26.0	251	17.7	597	42.0
	AA	1596	30.1	240	15.0	396	24.8	250	15.7	710	44.5
	Other	2279	43.0	310	13.6	679	29.8	333	14.6	957	42.0
Need factor
Other mental health conditions												***
	Yes	1877	35.4	349	18.6	476	25.4	294	15.7	758	40.4
	No	3418	64.6	404	11.8	968	28.3	540	15.8	1506	44.1
Enabling factors
Medicaid eligibility - poverty												**
	Yes	4620	87.3	1237	26.8	708	15.3	2014	43.6	661	14.3
	No	675	12.7	207	30.7	126	18.7	250	37.0	92	13.6
Medicaid eligibility - Medical Need												*
	Yes	638	12.0	181	28.4	108	16.9	238	37.3	111	17.4
	No	4657	88.0	1263	27.1	726	15.6	2026	43.5	642	13.8
Medicaid eligibility - Waiver
	Yes	300	5.7	89	29.7	60	20.0	114	38.0	37	12.3
	No	4995	94.3	1355	27.1	774	15.5	2150	43.0	716	14.3
Personal health practices
Oral Antidiabetic Drugs (OADs)												***
	1	1508	28.5	171	11.3	422	28.0	272	18.0	643	42.6
	2	1238	23.4	144	11.6	353	28.5	214	17.3	527	42.6
	3+	450	8.5	38	8.4	156	34.7	63	14.0	193	42.9
	None	2099	39.6	400	19.1	513	24.4	285	13.6	901	42.9
Insulin Use												***
	Yes	1827	34.5	277	15.2	512	28.0	148	8.1	890	48.7
	No	3468	65.5	476	13.7	932	26.9	686	19.8	1374	39.6
Polypharmacy												***
	Yes	1915	36.2	293	15.3	345	18.0	295	15.4	982	51.3
	No	3380	63.8	460	13.6	1099	32.5	539	15.9	1282	37.9
Inpatient hospitalization												***
	Yes	2604	49.2	534	20.5	532	20.4	232	8.9	1306	50.2
	No	2691	50.8	219	8.1	912	33.9	602	22.4	958	35.6
Outpatient visits												***
	1st quartile	1392	26.3	85	6.1	588	42.2	294	21.1	425	30.5
	2nd quartile	1221	23.1	139	11.4	352	28.8	215	17.6	515	42.2
	3rd quartile	1352	25.5	227	16.8	282	20.9	180	13.3	663	49.0
	4th quartile	1330	25.1	302	22.7	222	16.7	145	10.9	661	49.7
		Mean ± SE		Mean ± SE		Mean ± SE		Mean ± SE		Mean ± SE
Number of T2DM-related office visits		6.93 ± 0.13		7.98 ± 0.29		6.51 ± 0.29		5.44 ± 0.21		7.40 ± 0.19
Number of ER visits		1.18 ± 0.03		1.65 ± 0.11		0.66 ± 0.04		0.78 ± 0.05		1.51 ± 0.05
External environment
State												***
	Illinois	1502	28.4	211	14.0	379	25.2	256	17.0	656	43.7
	New York	2550	48.2	402	15.8	725	28.4	405	15.9	1018	39.9
	Texas	1243	23.5	140	11.3	340	27.4	173	13.9	590	47.5
HPSA- mental health care												*
	Yes	4405	83.2	651	14.8	1209	27.4	679	15.4	1866	42.4
	No	890	16.8	102	11.5	235	26.4	155	17.4	398	44.7
Metro												**
	Yes	4719	89.1	698	14.8	1291	27.4	730	15.5	2000	42.4
	No	576	10.9	55	9.5	153	26.6	104	18.1	264	45.8
CMHC
	Yes	2590	48.9	376	14.5	702	27.1	393	15.2	1119	43.2
	No	2705	51.1	377	13.9	742	27.4	441	16.3	1145	42.3
FQHC												**
	Yes	4365	82.4	651	14.9	1199	27.5	674	15.4	1841	42.2
	No	930	17.6	102	11.0	245	26.3	160	17.2	423	45.5
Median income												**
	1st quartile	1312	24.8	145	11.1	365	27.8	204	15.5	598	45.6
	2nd quartile	1415	26.7	199	14.1	378	26.7	246	17.4	592	41.8
	3rd quartile	1235	23.3	182	14.7	345	27.9	190	15.4	518	41.9
	4th quartile	1333	25.2	227	17.0	356	26.7	194	14.6	556	41.7
% with GT 4 years college education > 16%^a												**
	Yes	4399	83.1	656	14.9	1197	27.2	704	16.0	1842	41.9
	No	896	16.9	97	10.8	247	27.6	130	14.5	422	47.1
% below poverty level GT 11.1%^b				753		1444		834		2264
	Yes	4692	88.6	675	14.4	1284	27.4	732	15.6	2001	42.6
	No	603	11.4	78	12.9	160	26.5	102	16.9	263	43.6
		Mean ± SE		Mean ± SE		Mean ± SE		Mean ± SE		Mean ± SE
Density of Social Workers		3.01 ± 0.02		3.27 ± 0.06		3.02 ± 0.04		3.02 ± 0.06		2.91 ± 0.04

Note: Study sample was comprised of adults with type 2 diabetes mellitus aged 18–64 years with at least one coexisting dominant, concordant, or discordant chronic physical condition and who were alive, not dually eligible for Medicare, and continuously enrolled in fee-for-service Medicaid for at least 24 months (N = 5295); includes Medicaid data from three states: Illinois, Texas, New York
Asterisks (*) represent significant differences in study population characteristics and coexisting chronic physical condition categories (e.g. Dominant, Concordant Only, Discordant Only, and Both Concordant and Discordant), derived from chi-square statistics
***P < .001; **.001 ≤ P < .01; *.01 ≤ P < .05
^a16 % cutoff was chosen based on 2000 Census Education attainment results
^b11.1 % cutoff was chosen based on 1999 Census Poverty in people aged 18–64 years results
HPSA Health Professional Shortage Area, CMHC Community Mental Health Clinic, FQHC Federally Qualified Health Clinic, GT Greater Than

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ISSN: 1471-244X

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