The economic burden of inpatient care of depression in Poznan (Poland) and Kiel (Germany) in 2016.
Tomasz ZaprutkoRobert GöderKrzysztof KusWiktor PałysFilip RybakowskiElżbieta NowakowskaPublished in: PloS one (2018)
Depression is a global health problem associated with a significant public health burden and costs. Although studies on costs of diseases are being considered as an increasingly important factor for health policies, information concerning costs of inpatient care of depression is still insufficient. Thus, the main aim of this study was to evaluate costs of hospitalization of patients treated in 2016 in psychiatric clinics in Poznan (Poland) and in Kiel (Germany) and to analyze treatment used in these centers. The study was conducted from September 2017 to February 2018. 545 hospital records were considered (187 in Poznan and 358 in Kiel). Eventually, 490 hospital records were included, 168 in Poland and 322 in Germany. In general, the costs were calculated based on the patients' sex and diagnosis (F32 and F33) separately and, subsequently, the outcomes were added and multiplied by the length of hospital stay, giving the cost of hospitalization. The annual cost of inpatient care of depression in 2016 was EUR 491,067.19 ([Formula: see text]) in Poznan and EUR 2,847,991.00 [Formula: see text] in Kiel. In Poznan, hospitalization was underfunded reaching EUR 183,042.55 (37.27% of total costs in Poznan). In Poznan, the most frequently prescribed medicine was quetiapine, followed by olanzapine and venlafaxine, whereas in Kiel it was venlafaxine, followed by mirtazapine and promethazine. Although non-pharmacological therapies were commonly used in both centers, in Kiel this type of treatment was better structured. The study confirms the degree of the economic burden of inpatient care of depression. The underfunding of mental health revealed, emphasizes the need for urgent amendment of organization and funding of mental health care in Poland. Patients in Poznan were hospitalized on average 10 days longer than in Kiel, thus a reduction of length of hospitalization in Poznan seems possible. Although pharmacotherapy seemed to be comprehensive in both centers, there were some differences between Poznan and Kiel. Access to non-pharmacological therapies during outpatient care was limited in Poznan, however, compared to Kiel.
Keyphrases
- mental health
- palliative care
- healthcare
- public health
- depressive symptoms
- acute care
- end stage renal disease
- global health
- quality improvement
- sleep quality
- chronic kidney disease
- ejection fraction
- newly diagnosed
- primary care
- pain management
- emergency department
- prognostic factors
- affordable care act
- preterm infants
- peritoneal dialysis
- type diabetes
- chronic pain
- adverse drug
- risk assessment
- social media
- human health
- drug induced
- health insurance
- low birth weight
- replacement therapy