Maternal depressive symptoms predict adolescent healthcare utilization and charges in youth with type 1 diabetes (T1D)

Health Psychol. 2013 Sep;32(9):1013-22. doi: 10.1037/a0032761.

Abstract

Objective: To examine whether maternal depressive symptoms predict diabetes-related health care utilization and charges in adolescents with Type 1 diabetes.

Method: Mothers of adolescents ages 11-18 with Type 1 diabetes completed the Center for Epidemiological Studies Depression Scale at enrollment and at 12-month follow-up. Demographic and disease-related variables, including HbA1c, were also assessed. Health care utilization data and charges for diabetes-related care (i.e., endocrine clinic visits, emergency room visits, and hospitalizations) for the period of 12 and 24 months following enrollment were assessed.

Results: Maternal depressive symptoms at enrollment predicted higher utilization/charges at 12- and 24-month follow-up, after controlling for demographic and disease-related variables and adolescent depressive symptoms. High maternal depressive symptoms at baseline were associated with $8,405 additional charges over the next 2 years. Adolescents of mothers with high depressive symptoms were twice as likely to have an emergency room visit and three times as likely to have a hospitalization.

Conclusion: Maternal depressive symptoms are an independent predictor of health care utilization and charges in adolescents with Type 1 diabetes. Interventions aimed at identifying and treating depressive symptoms in mothers could not only enhance caregiver quality of life but could also be economically advantageous for payers and providers.

MeSH terms

  • Adolescent
  • Adolescent Health Services / economics*
  • Adolescent Health Services / statistics & numerical data*
  • Adult
  • Child
  • Depression / diagnosis*
  • Diabetes Mellitus, Type 1 / economics*
  • Diabetes Mellitus, Type 1 / therapy*
  • Fees and Charges / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Middle Aged
  • Mothers / psychology*
  • Mothers / statistics & numerical data
  • Psychiatric Status Rating Scales
  • Young Adult

Substances

  • Glycated Hemoglobin
  • hemoglobin A1c protein, human