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Published Online: September 2011

Direct Costs of Bipolar Disorder Versus Other Chronic Conditions: An Employer-Based Health Plan Analysis

Abstract

Objective:

This study was a retrospective data-based analysis of health care utilization and costs for patients diagnosed as having bipolar disorder compared with patients with diagnoses of depression, diabetes, coronary artery disease, or asthma.

Methods:

Data were from an employer-based health plan. Consistent diagnosis and continuous enrollment from 2004 to 2007 were used to identify the study population (total N=7,511), including those with bipolar disorder (N=122), depression (N=1,290), asthma (N=2,770), coronary artery disease (N=1,759), diabetes (N=1,418), and diabetes with coronary artery disease (N=455). Resource utilization quantified as cost (total, specialty care, psychiatric outpatient) and number of visits (specialty care and outpatient psychiatric care) was compared across groups.

Results:

Patients with bipolar disorder had higher adjusted mean per member per month (PMPM) costs than any other comparison group except for those with both diabetes and coronary artery disease. The cost was predominantly related to pharmacy costs and both inpatient and outpatient psychiatric care. A subset of 20% of patients with bipolar disorder accounted for 64% of the total costs. This subgroup of patients was more likely to be female, to have frequent hospital stays, and to have a higher number of comorbidities. Depressed patients, in contrast to bipolar disorder patients, had higher adjusted mean PMPM costs in primary care and nonpsychiatric inpatient costs.

Conclusions:

Health care costs for bipolar disorder exceeded those for several common chronic illnesses. These data provide further evidence for employers, insurers, and providers to seek innovative models to deliver effective and efficient care to individuals with bipolar illness. (Psychiatric Services 62:1073–1078, 2011)

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Figure 1 Total health care utilization costs per health plan member per month for 7,511 patients, by condition
Table 1 Characteristics of the study population, by type of disorder or illness
Table 2 Costs of utilizing health care services in an employer-sponsored health plan, by patients' condition
Table 3 Demographic characteristics of bipolar disorder patients accounting for the top 20% of health care costs and those accounting for other 80% in an employer-sponsored health plan

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Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: Approaching Thunder Storm, by Martin Johnson Heade, 1859. Oil on canvas, 28 × 44 inches. Gift of Erving Wolf Foundation and Mr. and Mrs. Erving Wolf, 1975. The Metropolitan Museum of Art, New York. Image © The Metropolitan Museum of Art/Art Resource, New York.
Psychiatric Services
Pages: 1073 - 1078
PubMed: 21885587

History

Published in print: September 2011
Published online: 14 January 2015

Authors

Details

Mark D. Williams, M.D.
Dr. Williams and Dr. Frye are affiliated with the Department of Psychiatry and Psychology, Dr. Shah and Ms. Wagie are with the Department of Health Care Policy and Research, and Dr. Wood is with the Department of Cardiovascular Diseases, all at the Mayo Clinic, 200 1st St. SW, Rochester, MN 55905 (e-mail: [email protected]).

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