The distribution of mental health service costs for depression in the alberta population

Objectives: In Canada, most mental health services are embedded in the public health care system. Little is known of the cost distribution within the mental health population. Our study aims to estimate the depression care costs of patients with a depression diagnosis, ranking them by the increasing total depression health care costs. Methods: For fiscal year 2007/08, we extracted administrative health care records from across the continuum, including physicians, outpatient services, and hospitals. Using a unique patient identifier, all service costs were merged for each person. Costs were summed by service categories and then divided by the served population into 10 equalsize groups. Further, we divided costs in the top decile into 10 percentile groups. Results: There were 208 167 people (5.9% of Albertans) who had at least 1 health care visit for depression. The total cost for depression treatment services was 114.5 million, an average 550 per treated person. In the first 9 deciles, most costs were for general practitioners. By the ninth decile, cost per person was about 400. Within the tenth decile, costs increased regularly, and in the top 1 percentile (1% of patients) there was an increase of cost per patient to 25 826 from 5792 in the previous percentile. Conclusion: Per person costs were highly skewed. Until the ninth decile, the cost increased slowly, consisting of mainly physician costs. In the last decile, costs increased substantially, mainly because of hospitalizations. Thus both primary care and specialist care play key roles.