Hospitalization for MDD Costly, Associated With High Readmission Rates

Hospitalizations for major depressive disorder (MDD) were costly and associated with high risk for readmission, according to study results published in the Journal of Affective Disorders.

Investigators abstracted data on hospital admissions for MDD between January 1, 2014, and December 31, 2015, from the Premier Perspective Hospital Database. Healthcare claims data from the Truven MarketScan Research Database were also evaluated, beginning with a 2013 index date. Records from patients ≥18 years with 1 or more inpatient admission for MDD were included in analysis. The clinical characteristics, treatment patterns, length of stay, and costs for each case were characterized at the encounter level. Time to hospital readmission and readmission rates were assessed at the patient level.

During 2014 to 2015, a total of 10,805,833 adult admissions were recorded in the Premier database. Of these, 136,704 (1.3%) included a primary diagnosis of MDD. The MarketScan database contained records from 2013 on 859,479 patients with MDD, among whom 34,379 (4.0%) had at least 1 MDD-related hospitalization. Patient demographics were similar between the Premier and MarketScan cohorts; patients were mean age 44 (±16) years in the Premier database and 41 (±17) years in the MarketScan database. Patients were primarily women in both the Premier (54.4%) and MarketScan (60.7%) cohorts.

Most MDD stays recorded in the Premier (71.2%) and MarketScan (61.8%) databases had a primary diagnosis of recurrent MDD, and between 40% and 60% of all MDD stays were associated with suicidal ideation or suicide attempt. According to Premier data, the majority of MDD hospital stays (89.3%) involved treatment with at least 1 antidepressant during the stay, and less than 13% stays included nonpharmalogical treatment. The mean length of stay per MDD hospitalization was 6 days in both samples. Per the Premier database, the mean total charge per stay was $6713, and 5.2% of inpatients had at least 1 readmission for MDD within 30 days of discharge. Using MarketScan data, the total reimbursed amount per stay was $8441 and 5.4% of those with an initial hospitalization had at least 1 readmission for MDD within 30 days.

Adult MDD-related hospitalizations are costly to patients and the healthcare system, and rehospitalization within 30 days of discharge is common. The researchers wrote, “These data suggest a need for new rapid-acting treatments, with durability and improved tolerability compared with conventional treatment.”

Disclosures: This study received funding from Allergan. See source complete disclosure information.

Reference

Citrome L, Jain R, Tung A, Landsman-Blumberg PB, Kramer K, Ali S. Prevalence, treatment patterns, and stay characteristics associated with hospitalizations for major depressive disorder. J Affect Disord. 2019;249:378-384.