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KMID : 1146320210090020068
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Journal of Health Technology Assessment
2021 Volume.9 No. 2 p.68 ~ p.77
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Incremental Economic Burden of Comorbid Major Depressive Disorder in Adult Atopic Dermatitis Patients: A Retrospective Cross-Sectional Study
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Lee Eun-Chan
Kang Hye-Young
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Abstract
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Objectives: This study aims to assess the incremental economic burden of major depressive disorder (MDD) in adult atopic dermatitis (AD) patients.
Methods: A retrospective, cross-sectional study was performed using 2018 Health Insurance Review and Assessment Service-National Patient Sample data. The incremental economic burden was assessed between adult AD patients with MDD (AD with MDD) and adult AD patients without MDD (AD without MDD). We defined adult AD patients as those aged≥20 years who had at least two claim records with diagnosis of AD. AD with MDD were defined as AD patients having at least two claim records with diagnosis of MDD. AD without MDD were defined as those who had no claim record with diagnosis of MDD. AD without MDD matched by propensity score according to age, gender, and type of national security program were defined using a 1:2 greedy matching method. Medical costs were estimated by National Health Insurance (NHI)-covered medical costs. The ratio of medical costs between AD with MDD and matched-AD without MDD was adjusted for Charlson Comorbidity Index in the generalized linear model.
Results: AD with MDD (n=371) had statistically higher hospital admission risk and outpatient visits (1.86-fold, p<0.0001) and tertiary-care hospital visits (2.86-fold, p<0.0001) compared to matched-AD without MDD (n=742). The annual average NHI-covered medical costs per patient were estimated to be 4,903,870 Korean Won (KRW) for AD with MDD and 2,804,183 KRW for matched-AD without MDD, resulting in cost ratio of 1.75-fold (p<0.0001). In the multivariate regression model, the medical cost per patient was 1.45-fold (95% Cl: 1.30?1.62) higher for AD with MDD than matched-AD without MDD.
Conclusion: This study demonstrates a significant incremental economic burden of comorbid MDD in adult AD patients. Thus, greater emphasis on the prevention and treatment of MDD in adult AD patients is warranted.
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KEYWORD
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Atopic dermatitis, Healthcare utilization, Major depressive disorder, Medical cost, Generalized linear model
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