Pharmacy and Therapeutics - January 2008 - (Page 24) Impact of Bipolar Disorder on the Family Table 2 Percentage of Families with a Medical Claim for a Diagnosis within a Major Diagnostic Category Major Diagnostic Category 00 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Families with a Bipolar Member 3.20 4.63 3.65 9.95 5.99 5.31 6.24 0.87 8.93 9.08 4.91 3.38 1.14 3.63 0.44 0.28 1.48 0.47 2.10 9.72 0.75 2.71 0.17 10.93 0.02 0.02 100.00 Matched Families 3.36 3.36 4.62 12.55 6.14 5.96 6.32 0.69 9.77 10.72 4.93 3.27 1.41 3.81 1.09 0.88 1.38 0.56 2.38 0.00 0.00 1.98 0.12 14.68 0.01 0.01 100.00 Ungroupable Nervous System Eye Ear, Nose, Mouth, and Throat Respiratory System Circulatory System Digestive System Hepatobiliary System Musculoskeletal System and Connective Tissue Skin, Subcutaneous Tissue, and Breast Endocrine, Nutritional, and Metabolic System Kidney and Urinary Tract Male Reproductive System Female Reproductive System Pregnancy, Childbirth, and Puerperium Newborns and Other Neonates (Perinatal Period) Blood and Blood Forming Organs and Immunological Disorders Myeloproliferative Diseases and Disorders (Poorly Differentiated Neoplasms) Infectious and Parasitic Diseases Mental Diseases and Disorders Alcohol/Drug Use or Induced Mental Disorders Injuries, Poison, and Toxic Effect of Drugs Burns Factors Influencing Health Status Multiple Significant Trauma Human Immunodeficiency Virus Infection TOTAL tial in per-member health care costs, at a rate that was 203% higher than their matched counterparts. Table 5 summarizes the results of the regression analysis of the relationship, after we controlled for other family demographic and health status variables, between the natural log of total health care costs for families and having a family member with bipolar disorder. After we controlled for comorbidities and family size, the regression model estimates showed that total health care costs for bipolar families were nearly 1.5 times greater (e0.383 =1.47) than for families without any serious mental illness. DISCUSSION Our analysis provides new information about bipolar disorder and its effects on families. It reports a conservative estimate of the incremental health care cost associated with bipolar disorder in a specific American population. The results suggest that diagnosed and potentially treated bipolar disorder is associated with a substantial increase in the utilization of health care resources and costs for families. Even after we controlled for some potentially confounding factors in a multivariate model, the impact persisted, although it was somewhat diminished. It is notable that the factors included in the regression model explained 66% of the variability in total health care costs for families. In our study, total annual health care costs were 239% higher for bipolar families than for matched controls; these costs were similar to those noted by Gianfrancesco et al.13 In that study, annual mental health care expenses for bipolar families were 213% higher, and other health care expenses were 7.4% higher than in families without bipolar disorder, major depression, or schizophrenia.13 Our study group was drawn from several regions of the U.S. and encompassed multiple insurers and plan designs, thereby providing a way to apply the results to other groups with commercial health insurance. Bipolar families used significantly more health care resources and incurred significantly greater costs, although nearly 90% of these resources and costs were used to treat conditions other than bipolar disorder. There were more diagnoses of comorbid conditions in these families, as indicated by the higher mean number of MDCs. A similar trend was seen in a study by Stang et al. In that study, only 5% of total health care costs for families with a migraineur were used for the treatment of migraine.15 Studies have shown that caregivers of children with chronic medical conditions or physical disabilities have higher levels of anxiety and depression as well as more complaints of physical problems.16–20 Elevated levels of depressive symptoms and physical health problems for caregivers of patients with dementia have also been reported.21,22 24 P&T® • January 2008 • Vol. 33 No. 1
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.