Critical Review of the Literature: The Cost of Managing Adult Depression in the Primary Care Setting

Micheal Kelly

Date of Award

2002

Document Type

Thesis

College/School

College of Nursing

Degree Name

Master of Science in Nursing (MSN)

Program Concentration

Family Primary Care Nurse Practitioner

Abstract

Depression has become one of the most common illnesses in the United States today. At any given time 10%, or about 27 million people in the United States, suffer from depression. Direct and indirect costs of treating depression have been estimated at $43 billion annually. There are many factors that influence the costs of treating depression in the primary care setting. These include, but are not limited to, the severity of the illness, costs and number of visits for treatment, pharmaceuticals, and the use of specialty mental health professionals. Costs and benefits of treatment are not only a concern of medical and insurance fields but employers, family members, and society. This paper serves as a critical review of the literature of studies that have examined the costs of treating depression in the primary care setting. Four major limitations were identified that question the usability of these studies. These limitations include a lack of a definition for the term "usual care", use of diverse diagnostic criteria, criteria that excluded subjects with a comorbid illness, and a lack of uninsured subjects in the studies. Costs of treating depression in these studies varied greatly from $313 to $2,279 annually. These treatment costs are an integral component in the management of depression. Most depressed patients typically present in the primary care setting with symptoms other than depression. This emphasizes the importance of the nurse practitioner, as a primary care provider, being knowledgeable in the recognition, treatment, and the costs involved with depression.

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