Research & Publications
Relationship Between Social Determinants of Health and Hospitalizations and Costs in Patients With Major Depressive Disorder
Summary
Major depressive disorder (MDD) is a debilitating, episodic, and recurrent illness and the second leading cause of disability in the United States, affecting millions of Americans. MDD patients with social risk factors — such as income, education, and social support — have even higher risk of worse health outcomes resulting in higher healthcare costs for people with MDD.
This study analyzed data from nearly 2 million patients with MDD who had Commercial or Medicaid insurance to understand how social drivers of health (SDOH) influence hospitalizations and medical costs. Researchers found that Medicaid patients faced greater social challenges, including lower incomes, lower education levels, and higher rates of living alone. Nearly one-third (29.6%) of Medicaid patients were hospitalized compared to 14.7% of commercially insured patients, with longer hospital stays (6.8 days vs. 5.9 days) and higher total healthcare costs. Household income was perfectly inversely associated with hospitalizations, with increasingly higher rates of inpatient stays at lower levels of income for both populations. Limited English proficiency and lower education were linked to fewer hospitalizations and lower costs in Medicaid patients but higher hospitalizations and costs in commercially insured patients, suggesting disparities in access to care.
Why This Matters
These findings highlight the need to address healthcare disparities for people with MDD, particularly among those with lower incomes, low language proficiency, and availability of mental health practitioners. Policies and interventions aimed at addressing these social risk factors could improve access to mental health care and help reduce hospitalizations leading to better health outcomes and lower costs for patients with major depression.
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