Abstract 215: GenderDisparities in Health Care Expenditure Among Patients With MI and Depression ResultsFrom the Medical Expenditure Panel Survey 2014


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Abstract

Introduction: Previous studies have linked depression and cardiovascular diseases, however gender differences in cost of hospitalization and care associated with events related to depression and myocardial infarction (MI) is not studied in detail. We utilized data from 2014 Medical Expenditure Panel Survey (MEPS) to evaluate national estimates of such costs.Hypothesis: Proportion of depression and MI and corresponding healthcare expenditures are high in general population and differ between genders. Also, payments are appropriated differently between payers.Methods: Participants from 2014 MEPS with events attributed to MI and/ or depression were included in this study. Mean (95% CI) event related cost, and total cost of health care was calculated using survey methods. Expenditure and utilization cost was grouped as related to ambulatory, emergency room, inpatient, home visits and medications. By source, payments were grouped as paid by family, MEDICARE, MEDICAID, private insurance, VA, Tricare and other.Results: There were 23486 participants in the study, representing 242,628,543 individuals in the US who were 20 years or above. Total health expenditure in 2014 among these was $1.5 trillion (Males: $696,940,498,022; Females: $837,486,094,699) with $27,937,582,549 attributed to depression (Males: $10,991,761,342; Females: $16,945,821,207) and $51,142,260,003 to MI (Males: $40,676,887,518; Females: $10,465,372,485). There were around 6,174,408 (2.5%) and 27,269,837 (11.2%) events associated with MI and depression respectively. Approximately 901,762 individuals reported both events. Among males, MI was 4,189,696 (3.6%) and among females, 1,984,711 (1.6%). Depression was reported 8,755,276 (7.5%) among males and 18,514,560 (14.6%) among females. Among females who were depressed, 2.3% reported MI, and 1.4% among those who were not depressed. Among males who were depressed, 5.4% reported MI and 3.4% among those who were not depressed. Among depressed males, AMI hospitalization was 0.31% whereas among depressed females, AMI hospitalization was 0.24%.Conclusion: Among both depressed and non-depressed populations, males had significantly higher proportion of MI and hospitalizations related to AMI when compared to females. But, out of total MI costs for males, less than 1% cost was accrued by depressed; whereas, of total MI cost for females, 9.6% of cost was accrued by depressed females showing gender based disparities in healthcare cost and utilization. With Medicare paying between 78%-83% of all MI costs, treating depression can result in significant savings.

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