Friday, May 3, 2019

Comorbid Depression in Youth May Lengthen Hospital Stay, Increase Costs

Children and adolescents with depression who are hospitalized for illnesses such as appendicitis, asthma, diabetes-related complications, or pneumonia stay longer, incur more costs, and have a higher risk of death, according to a study in the Journal of Affective Disorders.

Mayowa Olusunmade, M.D., M.P.H., of Rutgers New Jersey Medical School and colleagues analyzed 2012 data from the Kids’ Inpatient Database, a national database of inpatient admissions in the United States for patients under 21 years. They compared the records of 17,071 children and adolescents with depression who were admitted for common conditions with an equal number of children and adolescents who were also admitted for these conditions but did not have depression.

The researchers found that those with depression stayed in the hospital nearly a day longer than those without depression. The total hospital costs for those with depression were on average nearly $3,000 higher than those without depression, and those with depression had a 77% greater odds of dying. In a second analysis involving only children younger than 13 years, the researchers found that total hospitalization costs more than doubled for children with depression compared with those without depression, and children with depression stayed in the hospital almost twice as long as their peers without depression.

“Possible explanations for increased lengths of stay and hospitalization costs in depressed children include passive coping strategies and decreased motivation, lower endurance thresholds for symptoms of acute illness, mood symptoms exacerbating symptoms of acute illness, and more care coordination needs as compared to children without comorbid depression,” Olusunmade and colleagues wrote.

The researchers called for hospitals to allocate more resources to mental health services that could promote faster referrals to psychiatric services.

The study “highlights the need for improved mental health programs and policies targeting depression prevention, screening, and early treatment in hospitalized children,” they concluded.

For related information, see the Psychiatric Services article “Behavioral Health Diagnoses Among Children and Adolescents Hospitalized in the United States: Observations and Implications.”

(Image: iStock/Stígur Már Karlsson/Heimsmyndir)


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