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The private sector is responsible for a substantial portion of treatment for mental and substance use disorders, with private insurance accounting for about 24% of mental and substance use disorder expenditures in 2005 [ 1].
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Hypertension and diabetes (the two most frequent chronic diseases in the study) were included to control for its confounding effect, as previous studies have shown its association with both mental disorders and health expenditures [ 18], and to compare its effects on health costs with the effect of mental disorders.
Our analysis found a robust association of depression, anxiety and any mental disorder with incremental health expenditure and lost days of normal activity, even in a country with a universal free-of-charge healthcare system.
ClinicalTrials.gov: NCT02245373 Major depressive disorder (MDD) generates high expenditure that is caused largely by its high prevalence, its recurrence and chronicity and because it usually affects young people of working age [ 1, 2].
Second, it was based on a cross-sectional survey, so the temporal association between mental disorders and health expenditure and lost days of normal activity was not established.
Escitalopram which treats depression and anxiety accounts for the highest expenditure (€0.74 m; 1 % of 'N') for 16 to 24 year olds and Olanzapine which treats psychotic conditions such as schizophrenia and bipolar disorder accounts for the highest expenditure (€2.48 m; 1 % of 'N') for 25 to 34 year olds.
The difference between these probably reflected the much lesser amount expended on TTH, while the low ratios for MOH (1.8) and other headache on ≥15 days/month (2.4) were, even more probably, similarly influenced by the potentially impoverishing expenditures on these disorders.
We examined the association of depression, anxiety and any mental disorders with incremental health expenditure, i.e. the linear increase in health expenditure associated with mental disorders, and lost days of normal activity.
In Canada, medical expenditures with respect to back disorders are estimated between $6 and $12 billion annually [ 5].
Expenditures on inpatients with schizophrenia as compared to expenditures on those with neurotic disorders were 120% higher among NHI beneficiaries but 83% higher among AID beneficiaries.
The objective of the present study is to examine the association of mental disorders with overall health expenditure and lost days of normal activity, by analyzing a representative sample of the Metropolitan Region of São Paulo, Brazil.
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Justyna Jupowicz-Kozak
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