The following is a summary of “Impact of depressive symptoms on Direct Medical Cost among medicare recipients with knee osteoarthritis,” published in the July 2024 issue of Rheumatology by Yang et al.

Depressive symptoms are prevalent among patients with knee osteoarthritis (KOA) and have significant implications for medical costs. This study compared the direct medical costs among Medicare Current Beneficiary Survey (MCBS) respondents with KOA, stratified by the presence and treatment status of self-reported depressive symptoms.

Using ICD-9/10 diagnostic codes from Part A and Part B claims to span 2003 to 2019, researchers identified a cohort of community-dwelling MCBS respondents diagnosed with KOA. Depressive symptoms were assessed through self-reported data on feelings of sadness or anhedonia. Participants were categorized into three groups based on their depressive symptom status: no depressive symptoms, depressive symptoms reported but no billable depression-related services, and depressive symptoms reported with billable depression-related services. A generalized linear model with log-transformed outcomes was employed to compare annual direct medical costs across these groups, adjusting for age, gender, race, history of fall, Total Joint Replacement, comorbidities, and calendar year.

Among the 4,118 MCBS respondents with KOA, 27% reported depressive symptoms, with 6% receiving billable depression-related services. Adjusted mean direct medical costs were $8,598 per year for those without depressive symptoms, $9,239 per year for those with depressive symptoms but no billable services, and $14,229 per year for those with depressive symptoms and billable services.

The findings highlight a significant prevalence of self-reported depressive symptoms among Medicare beneficiaries with KOA, with a minority receiving billable medical services for depression. Significantly, even in cases where depression was not treated with billable services, the presence of depressive symptoms was associated with notably higher direct medical costs. These results underscore the importance of addressing depressive symptoms in KOA management strategies to mitigate associated healthcare expenditures.

Source: sciencedirect.com/science/article/abs/pii/S1063458424011749