The impact of psychological interventions on medical cost offset: a meta-analytic review

Abstract

The impact of psychological interventions on the use of medical services was evaluated by examining the outcome of 91 studies published between 1967 and 1997 using meta-analytic techniques and percentage estimates. Psychological treatments included various forms of psychotherapy, behavioral medicine, and psychiatric consultation. Patients included those undeqping medical procedures such as surgery, patients with a history of overutilization, and patients being treated only for psychological disorderr including substance abuse. Results provided evidence for a medical costoffset effect, specifically in the domain of behavioral medicine. Average savings resulting from implementing psychological interventions was estimated t o be about 20%. About one third of the articles demonstrated that dollar savings continued t o be substantial even when the cost of providing the psychological intervention was subtracted from the savings. The role of moderating vari8bles such as patient age and type of problem was analyzed and discussed. Key words: m e d i a l cost offset, meta-analysis. psychotherapy outcome, overutilization of medical services, behavioral medicine. [C/in Psycho/ Sci Prac 6: 204-220, f9991

Health Care Reform: Preparing the Psychology Workforce

“…While evidence-based psychological treatment outcome research provides robust data to support inclusion of such services within the evolving, integrated, interprofessional health care system, clinical outcomes that are cost effective and actually can contribute to cost savings in this accountable system will be expected and be beneficial to the field. Thus, continued collection of medical cost offset research data that supports psychological services (Chiles, Lambert, & Hatch, 1999;Tovian, 2004) should be built into routine program evaluation, be a core skill taught to the next generation of healthcare psychologists, and routinely reported in the literature, so that advocates for psychology can use that information in discussions with policy makers.…”

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“…Studies aimed at reducing costs using psychosocial interventions have also targeted patients presenting primarily with physical illness. A comprehensive meta-analysis of 91 medical cost offset studies in medical populations published between 1967 and 1997 concluded that 90% of the studies reported some degree of decreased medical utilization following psychological intervention [73]. The estimated savings were $1,759 USD per person over all of these studies.…”

Better health, less spending: Redesigning the transition from pediatric to adult healthcare for youth with chronic illness

“…12 Treatable mental health conditions, particularly anxiety and depression, are common comorbidities of chronic illness in AYA 13 and are associated with poor health status 14 and greater cost compared to chronic illness without comorbid mental health conditions. 15 …”

“…40,41 Psychological interventions for anxiety and depression are effective 42 and have been shown to decrease medical costs, with the largest effects demonstrated for treatment integrated with medical care. 15 Despite this, 66% of AYA with mental illness do not receive care. 43 Web-based cognitive behavioral therapy (CBT) is effective and feasible for treating mild-to-moderate anxiety and depression in young adults.…”