Healthcare costs and resource utilization of patients with chronic post-traumatic stress disorder: a retrospective US claims analysis of commercially insured patients
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: Exploring the healthcare costs and resource use among privately insured US patients with post-traumatic stress disorder (PTSD). Methods: This study used Merative MarketScan data. The index date was defined as the first PTSD claim. Study period included a 1-year pre-index and 2-year post-index follow-up. Cases with only acute PTSD, cancer, or insurance gap during the study period were excluded. The PTSD with (PwC) and PTSD without comorbidities (PwoC) cohorts were defined by the presence/absence of comorbid mental health conditions (schizophrenia, bipolar and major depressive disorder). Baseline PTSD (BP) cohort included PwoC cases with only index PTSD event and without FDA-approved PTSD medications or psychotherapy. Sub-analysis is conducted among patients with PTSD and substance/alcohol use disorder. Study cohorts were matched in a 1:1:1 ratio. Results: The matched sample included 5076 patients (1681 PwC, 1681 PwoC, 1714 BP). PwC patients had higher 2-year PTSD-related costs than PwoC and BP patients ($3762 vs $1750 and $841; all p < 0.001). The same trend was noted among all-cause and anxiety-related costs. PwC patients had higher 2-year PTSD-related inpatient and emergency department (ED) rates than PwoC (10.2% vs 1.7% and 6.8% vs 2.6%, all p < 0.001) and inpatient and outpatient rates than BP (10.2% vs 2.1% and 98.0% vs 93.1%; all p ≤ 0.004). The sub-analysis had 3776 patients (3154 PwC, 537 PwoC, 85 BP). PwC had higher 2-year PTSD-related costs than PwoC and BP ($7668 vs $2919 and $1,483; all p < 0.001). The same trend was noted in all-cause and anxiety-related costs. PwC also had higher 2-year PTSD-related inpatient and ED rates than PwoC (25.6% vs 10.4% and 12.7% vs 5.2%; all p < 0.001) and inpatient and outpatient rates than BP (25.6% vs 8.2% and 95.5% vs 84.7%; all p < 0.001). Conclusion: PTSD is associated with high healthcare costs and resource use. The highest economic burden was observed in patients with PTSD and mental health comorbidities.
Plain language summary
Healthcare Costs & resource use of patients with post-traumatic stress disorder (PTSD)
What is this article about?
The research evaluated the economic burden of patients with PTSD classified by disease severity. Healthcare costs and resource use were assessed during the 2-year period after the diagnosis of PTSD. In addition, study outcomes were also explored among patients diagnosed with PTSD and substance/alcohol use disorder (SUD/AUD).
What were the results?
All-cause and PTSD-related healthcare costs and resource use were explored among Baseline PTSD, PTSD without comorbidities and patients with PTSD and mental health comorbidities. The most relevant results were:
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Patients with PTSD and comorbidities had higher total all-cause and PTSD-related costs than PTSD without comorbidities and Baseline PTSD
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The majority of healthcare costs occurred during the first year after PTSD diagnosis in all study cohorts
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Patients diagnosed with PTSD and SUD/AUD had higher healthcare costs, with the highest expenses noted among patients with PTSD and comorbidities
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Patients with PTSD and SUD/AUD and mental comorbidities had higher usage rates of hospitalizations and emergency department visits than Baseline PTSD and PTSD without comorbidities
What do the results mean?
PTSD is associated with large healthcare costs and resource use, with the highest economic burden observed in patients with PTSD and comorbidities.
Tweetable abstract
#post-traumaticStressDisorder (#PTSD) is associated with high #HealthcareCosts and #ResourceUse per patient, especially in #PTSDwithComorbidities. Co-occurrence of #SubstanceUseDisorder or #AlcoholUseDisorder among patients with PTSD yielded higher #EconomicBurden for #USHealthcare.
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© 2024 The authors. This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License
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Received: 10 April 2024
Accepted: 22 October 2024
Published online: 13 November 2024
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Healthcare costs and resource utilization of patients with chronic post-traumatic stress disorder: a retrospective US claims analysis of commercially insured patients. (2024) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2024-0058
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