Demographic Characteristics, Healthcare Cost, and Treatment Patterns Among Patients With Major Depressive Disorder and Suicidal Ideation or Suicide Attempt Who Received Treatment at a Hospital

Introduction: Major Depressive Disorder (MDD) is a leading cause of disability and a major risk factor for suicide. MDD patients who are suicidal(MDD+SI) are often evaluated in the emergency room (ER) and then hospitalized. This study examined characteristics, healthcare costs, and treatment patterns of these high-risk populations.

Methods: This retrospective observational study used IBM MarketScan Commercial Claims and Encounters database (2015-2017) to examine adults with MDD (≥2 outpatient diagnoses or ≥1 inpatient/ER diagnosis, or ≥1 antidepressant fill with ≥1 diagnosis within 90 days of the fill) and adults with MDD+SI (≥1 hospital encounter with both a MDD and a suicidal ideation/suicide attempt diagnosis and ≥1 antidepressant fill). Continuous enrollment ≥6 months pre- and ≥12 months post-index was required.

Results: Of 722,802 patients with MDD, 2,626 (0.4%) had MDD+SI. Of them, 67.5% were female; mean (SD) age was 35.5 (14.9) years. Most MDD+SI patients (93.1%) had inpatient encounters with a mean (SD, median, range) length of stay of 9.0 (12.3, 6.0, 1-227) days. Mean (SD) all-cause costs were as follows: MDD, $14,402 ($39,019); MDD+SI, $35,950 ($91,418). Higher MDD+SI costs were driven by inpatient hospitalization and outpatient costs. Of 2,625 MDD+SI patients discharged, 18.5%, 23.2% and 26.4% were readmitted within 30, 60, or 90 days, respectively; within 6 months of discharge, 29.3% had a psychiatric visit, which occurred on average (SD, median, range) within 12.4 (19.7, 6.0, 1-179) days.

Conclusions: Patients with MDD+SI have several-fold greater healthcare costs than patients with MDD, underscoring the significant economic burden on the healthcare system.

This poster was presented at the 32nd annual Psych Congress, held Oct. 3-6, 2019, in San Diego, California.