Introduction
Differences in healthcare utilization and medical expenditures associated with perinatal
depression are estimated.
Methods
Using the MarketScan Multi-State Medicaid Database, the analytic cohort included individuals
aged 15–44 years who had an inpatient live birth delivery hospitalization between
January 1, 2017 and December 31, 2018. Multivariable negative binomial regression
models were used to estimate the differences in utilization associated with perinatal
depression, and multivariable generalized linear models were used to estimate the
differences in expenditures associated with perinatal depression. Analyses were conducted
in 2021.
Results
The cohort included 330,593 individuals. Nearly 17% had perinatal depression. Compared
with individuals without perinatal depression individuals with perinatal depression
had a larger number of inpatient admissions (0.19, 95% CI=0.18, 0.20), total inpatient
days (0.95, 95% CI=0.92, 0.97), outpatient visits (14.02, 95% CI=13.81, 14.22), emergency
department visits (1.70, 95% CI=1.66, 1.74), and weeks of drug therapy covered by
a prescription (28.70, 95% CI=28.12, 29.28) and larger total expenditures ($5,078,
95% CI=$4,816, $5,340). Non-Hispanic Black individuals had larger differences in utilization
and expenditures for inpatient services and outpatient visits but smaller differences
in utilization for pharmaceutical services associated with perinatal depression than
non-Hispanic White individuals. Hispanic individuals had larger differences in utilization
for outpatient visits but smaller differences in utilization for pharmaceutical services
associated with perinatal depression than non-Hispanic White individuals.
Conclusions
Individuals with perinatal depression had more healthcare utilization and medical
expenditures than individuals without perinatal depression, and differences varied
by race/ethnicity. The findings highlight the need to ensure comprehensive and equitable
mental health care to address perinatal depression.
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Article Info
Publication History
Published online: February 25, 2022
Identification
Copyright
Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
