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BioPsychoSocial Medicine

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Open Access 01-12-2015 | Review

Inpatient and outpatient costs in patients with coronary artery disease and mental disorders: a systematic review

Authors: Harald Baumeister, Anne Haschke, Marie Munzinger, Nico Hutter, Phillip J Tully

Published in: BioPsychoSocial Medicine | Issue 1/2015

Abstract

Background

To systematically review in- and outpatient costs in patients with coronary artery disease (CAD) and comorbid mental disorders.

Methods

A comprehensive database search was conducted for studies investigating persons with CAD and comorbid mental disorders (Medline, EMBASE, PsycINFO, Psyndex, EconLit, IBSS). All studies were included which allowed a comparison of in- and outpatient health care costs (assessed either monetarily or in terms of health care utilization) of CAD patients with comorbid mental disorders (mood, anxiety, alcohol, eating, somatoform and personality disorders) and those without. Random effects meta-analyses were conducted and results reported using forest plots.

Results

The literature search resulted in 7,275 potentially relevant studies, of which 52 met inclusion criteria. Hospital readmission rates were increased in CAD patients with any mental disorder (pooled standardized mean difference (SMD) = 0.34 [0.17;0.51]). Results for depression, anxiety and posttraumatic stress disorder pointed in the same direction with heterogeneous SMDs on a primary study level ranging from −0.44 to 1.26. Length of hospital stay was not increased in anxiety and any mental disorder, while studies on depression reported heterogeneous SMDs ranging from −0.08 to 0.82. Most studies reported increased overall and outpatient costs for patients with comorbid mental disorders. Results for invasive procedures were non-significant respectively inconclusive.

Conclusions

Comorbid mental disorders in CAD patients are associated with an increased healthcare utilization in terms of higher hospital readmission rates and increased overall and outpatient health care costs. From a health care point of view, it is requisite to improve the diagnosis and treatment of comorbid mental disorders in patients with CAD to minimize incremental costs.

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Title: Inpatient and outpatient costs in patients with coronary artery disease and mental disorders: a systematic review
Authors: Harald Baumeister
Anne Haschke
Marie Munzinger
Nico Hutter
Phillip J Tully
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BioPsychoSocial Medicine / Issue 1/2015
Electronic ISSN: 1751-0759
DOI: https://doi.org/10.1186/s13030-015-0039-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Inpatient and outpatient costs in patients with coronary artery disease and mental disorders: a systematic review

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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