Depressive symptoms are prevalent among knee osteoarthritis (KOA) patients and may lead to additional medical costs. We compared medical costs in Medicare Current Beneficiary Survey (MCBS) respondents with KOA with and without self-reported depressive symptoms. We identified a KOA cohort using ICD-9/10 diagnostic codes in both Part A and Part B claims among community-dwelling MCBS respondents from 2003 to 2019. We determined the presence of depressive symptoms using self-reported data on sadness or anhedonia. We considered three groups: 1) without depressive symptoms, 2) with depressive symptoms, no billable services, and 3) with depressive symptoms and billable services. We used a generalized linear model with log-transformed outcomes to compare annual total direct medical costs among the three groups, adjusting for age, gender, race, history of fall, Total Joint Replacement, comorbidities, and calendar year. The analysis included 4118 MCBS respondents with KOA. Of them, 27% had self-reported depressive symptoms, and 6% reported depressive symptoms and received depression-related billable services. The adjusted mean direct medical costs were $8598/year for those without depressive symptoms, $9239/year for those who reported depressive symptoms and received no billable services, and $14,229/year for those who reported depressive symptoms and received billable services. While over one quarter of Medicare beneficiaries with KOA self-reported depressive symptoms, only 6% received billable medical services. The presence of depressive symptoms led to higher direct medical costs, even among those who did not receive depression-related billable services.

中文翻译：

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膝骨关节炎患者抑郁症状对直接医疗费用的影响

抑郁症状在膝骨关节炎 (KOA) 患者中普遍存在，可能会导致额外的医疗费用。我们比较了医疗保险当前受益人调查 (MCBS) 中患有 KOA 的受访者（有或没有自我报告的抑郁症状）的医疗费用。我们在 2003 年至 2019 年社区居住的 MCBS 受访者中使用 A 部分和 B 部分声明中的 ICD-9/10 诊断代码确定了一个 KOA 队列。我们使用自我报告的悲伤或快感缺失数据确定是否存在抑郁症状。我们考虑了三组：1）没有抑郁症状，2）有抑郁症状，没有收费服务，3）有抑郁症状和收费服务。我们使用具有对数转换结果的广义线性模型来比较三组之间的年度总直接医疗费用，并根据年龄、性别、种族、跌倒史、全关节置换术、合并症和日历年进行调整。该分析包括 4118 名患有 KOA 的 MCBS 受访者。其中，27% 的人自我报告有抑郁症状，6% 的人报告了抑郁症状并接受了与抑郁症相关的收费服务。对于那些没有抑郁症状的人，调整后的平均直接医疗费用为 8598 美元/年；对于那些报告抑郁症状但未接受计费服务的人来说，调整后的平均直接医疗费用为 9239 美元/年；对于那些报告抑郁症状并接受计费服务的人来说，调整后的平均直接医疗费用为 14,229 美元/年。虽然超过四分之一患有 KOA 的 Medicare 受益人自我报告有抑郁症状，但只有 6% 的人接受了收费医疗服务。抑郁症状的存在会导致更高的直接医疗费用，即使对于那些没有接受与抑郁症相关的收费服务的人也是如此。