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Health-Related Quality of Life and Utilities Among Patients With Depression in the Department of Veterans Affairs

Dr. Zivin, Dr. McCarthy, Dr. Valenstein, and Dr. Kilbourne are affiliated with the Department of Psychiatry and Mr. McCammon and Dr. Post are with the Department of Internal Medicine, both at the University of Michigan Medical School, Ann Arbor. Dr. McCarthy, Dr. Valenstein, Dr. Post, and Dr. Kilbourne are also with the Serious Mental Illness Treatment Research and Evaluation Center, Health Services Research and Development, Department of Veterans Affairs Ann Arbor, with which Ms. Welsh is also affiliated. Send correspondence to Dr. Zivin at the Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Rd., Box 5765, Ann Arbor, MI 48109 (e-mail: kzivin{at}umich.edu).

OBJECTIVE: This study establishes veteran-specific utility measures for patients with and those without depression. METHODS: A cross-sectional study was conducted of 87,797 Veterans Affairs (VA) patients who had completed the 12-Item Short-Form Health Survey (SF-12) portion of the VA's Large Health Survey of Veteran Enrollees administered in 1999 (58,442 veterans had an ICD-9 diagnosis of depression and 29,355 did not have such a diagnosis). RESULTS: All demographic and clinical comparisons were statistically significant between the two groups. Compared with veterans without depression, those with depression had lower mental component scores and physical component scores, indicating worse health. Utilities, an indication of health state, were lower for veterans with depression, indicating worse health. CONCLUSIONS: This is the first national study of utilities among veterans with and those without depression. Future research should investigate how treatment interventions may affect utilities and develop broader cost-effectiveness models of VA depression care.

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