Inpatient and outpatient costs in patients with coronary artery disease and mental disorders: a systematic review

Abstract: Background

To systematically review in- and outpatient costs in patients with coronary artery disease (CAD) and comorbid mental disorders.
Methods

A comprehensive database search was conducted for studies investigating persons with CAD and comorbid mental disorders (Medline, EMBASE, PsycINFO, Psyndex, EconLit, IBSS). All studies were included which allowed a comparison of in- and outpatient health care costs (assessed either monetarily or in terms of health care utilization) of CAD patients with comorbid mental disorders (mood, anxiety, alcohol, eating, somatoform and personality disorders) and those without. Random effects meta-analyses were conducted and results reported using forest plots.

Results

The literature search resulted in 7,275 potentially relevant studies, of which 52 met inclusion criteria. Hospital readmission rates were increased in CAD patients with any mental disorder (pooled standardized mean difference (SMD) = 0.34 [0.17;0.51]). Results for depression, anxiety and posttraumatic stress disorder pointed in the same direction with heterogeneous SMDs on a primary study level ranging from −0.44 to 1.26. Length of hospital stay was not increased in anxiety and any mental disorder, while studies on depression reported heterogeneous SMDs ranging from −0.08 to 0.82. Most studies reported increased overall and outpatient costs for patients with comorbid mental disorders. Results for invasive procedures were non-significant respectively inconclusive.

Conclusions

Comorbid mental disorders in CAD patients are associated with an increased healthcare utilization in terms of higher hospital readmission rates and increased overall and outpatient health care costs. From a health care point of view, it is requisite to improve the diagnosis and treatment of comorbid mental disorders in patients with CAD to minimize incremental costs.

Keywords

Coronary artery disease - Mental disorder - Depression - Comorbidity - Health care costs - Systematic review

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch
Anmerkungen
BioPsychoSocial Medicine. 9 (2015), 11, DOI 10.1186/s13030-015-0039-z, ISSN: 1751-0759

Schlagwort
Koronare Herzkrankheit
Psychische Störung
Depression
Sekundärkrankheit
Krankheitskosten
Überprüfung

Ereignis
Veröffentlichung
(wo)
Freiburg
(wer)
Universität
(wann)
2017
Urheber

DOI
10.1186/s13030-015-0039-z
URN
urn:nbn:de:bsz:25-freidok-125372
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
25.03.2025, 13:44 MEZ

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