Depressive symptoms and health costs in older medical patients

Am J Psychiatry. 1999 Mar;156(3):477-9. doi: 10.1176/ajp.156.3.477.


Objective: The authors assessed the association between depressive symptoms and health costs for a national Veterans Administration (VA) sample.

Method: The Rand Depression Index was administered to 1,316 medical or surgical inpatients over the age of 60 at nine VA hospitals. Scores were merged with utilization, demographic, and hospital data from national VA inpatient and outpatient files.

Results: Medical costs for respondents with the highest quartile of symptoms were approximately $3,200-or 50%-greater than medical costs for those in the least symptomatic quartile. Depressive symptoms were not associated with any statistically significant mental health expenditures.

Conclusions: The study extends previous reports of the high medical costs associated with depressive disorders to an older, public sector population. The mechanisms underlying increased medical costs associated with depressive symptoms, while the subject of much speculation in the literature, still remain largely unknown.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Depressive Disorder / diagnosis
  • Depressive Disorder / economics*
  • Depressive Disorder / epidemiology
  • Geriatric Assessment
  • Health Care Costs*
  • Health Care Surveys
  • Hospital Costs
  • Hospitals, Veterans / economics
  • Hospitals, Veterans / statistics & numerical data
  • Humans
  • Middle Aged
  • United States