Background In the elderly community, depressive symptoms are frequent and often disabling because of its association with other comorbidities. The objectives of this study were to explore, across Europe, out-of-pocket (OOP) health spending between individuals with and without depressive symptoms.
Methods We used baseline data from 10 countries participating in the Survey of Health, Aging and Retirement in Europe (SHARE). We included around 17 000 non-institutionalized individuals aged 50-79 years, with available, plausible income and OOP data. Depressive symptoms were diagnosed with the EURO-D depression symptoms scale. Previous 12 months OOPpayments, excluding health insurance premiums, were self-reported, and financial burden defined as the share of income spent in OOP. Whether individuals forwent care because of costs was considered as another outcome. Multivariate pooled and country- level regressions were performed on weighted data, adjusting for age, gender, marital status, education, and chronic diseases.
Results The estimated overall prevalence of depressive symptoms is 24.6%. Preliminary results show that individuals with depressive symptoms are more likely to spend $1% of income in OOP for outpatient care and prescribed drugs. Except for a few cases, similar trends were found at the country level. When considering $5% as the share of income spent in OOP, odds ratio varied more across countries for outpatient care. In addition, individuals with depressive symptoms are at increased risk of foregoing care because of costs, in all countries except Sweden.
Conclusions Our results show that across Europe, individuals with depressive symptoms bear a higher financial burden than those without them. In all countries, individuals forego care because of costs even when they face OOP higher than 5% of their income. Depression worsens the financial situation and the health of the elderly.