Behavioral medicine, clinical health psychology, and cost offset.

The health care system in the United States, plagued by spiraling costs, unequal access, and uneven quality, can find its best chance of improving the health of the population through the improvement of behavioral health services. It is in this area that the largest potential payoff in reduction of morbidity and mortality and increased cost-effectiveness of care can be found. A review of the evidence shows that many forms of behavioral health services, particularly when delivered as part of primary medical care, can be central to such an improvement. The evidence supports many but not all behavioral health services when delivered in settings in which people will accept these services under particular administrative and fiscal structures.Keywords: economics, cost offset, behavioral health, psychology, medical settings ALEXANDER BLOUNT received his EdD in counseling from the University of Massachusetts at Amherst. He is professor of clinical family medicine at the University of Massachusetts Medical School and director of behavioral science in the Department of Family Medicine and Community Health. He is chair of the Collaborative Family Healthcare Association. His areas of professional interest include the integration of behavioral health services into primary care settings and the training of primary care psychologists and family medicine residents. MICHAEL SCHOENBAUM received his PhD in economics from the University of Michigan. He is a researcher for the RAND Corporation. His interests include analyses of the Palestinian health system, identification of policy options for improving clinical performance and economic viability in health care, economic analyses for national trials to improve care for depression, and Web-based modeling and decision-support tools to help consumers make health benefits choices. ROGER KATHOL received his MD from the University of Kansas School of Medicine. He completed an internship in internal medicine at Good Samaritan Hospital in Phoenix, Arizona; residencies in psychiatry and internal medicine at the University of Iowa in Iowa City; and a year of endocrinology fellowship in Wellington, New Zealand. He is adjunct professor of internal medicine and psychiatry at the University of Minnesota Medical School. He has extensive experience in the integration of general medical and behavioral health care. He has international expertise in the development and operation of cross-disciplinary programs and services for clinics and hospitals; health plans; software vendors; case, disease, and disability management organizations; employee assistance programs; and employers. BRUCE L. ROLLMAN received his MD from Jefferson Medical School and his MPH from Johns Hopkins Medical School. He is an associate professor of medicine and psychiatry at the Center for Research on Health Care at the University of Pittsburgh. He is involved with the planning and implementation of clinical trials to improve the quality of treatment for depression and anxiety disorders in primary care settings and for patients wi...

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“…All were found to yield overall cost savings. (Statements below not specifically cited are found in Friedman et al, 1995).…”

Section: Core Findings From the Evidencementioning

confidence: 99%

The economics of behavioral health services in medical settings: A summary of the evidence.

Blount¹,

Schoenbaum²,

Kathol³

et al. 2007

Professional Psychology: Research and Practice

164

129

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“…Evidence suggests that improvements in HRQOL as a result of social support such as more visitors and support for women in labor result in decreased morbidity and as a result reduce medical costs (35). More than just diagnosis, breast cancer is costly to the Canadian health care system (10-13).…”

Section: Importance Of Our Studymentioning

confidence: 99%

Social support as a determinant of health-related quality of life in breast cancer survivors in California.

Rab

2013

JCO

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and Keywords Objective:To evaluate the relationship between perceived social support and HRQOL (physical and emotional) in low SES breast cancer survivors. Methods:A cross-sectional study design was used to measure perceived social support at 18 months and HRQOL at 3 years after breast cancer diagnosis using MOS SS and MOS SF-36, respectively. Multiple regression analyses were used to evaluate the relationship. Results:Menopause at the time of diagnosis, adjunct chemotherapy, adjunct radiation therapy, comorbidities, treatment side effects and depression were negatively associated with PCS scores (p < 0.01). Treatment side effects, anxiety and depression were negatively associated with MCS scores (p < 0.01). Conclusions:Perceived social support was not associated with HRQOL in low SES breast cancer survivors in our study. Menopause, co-morbidities, treatment side effect, adjunct chemotherapy and radiation therapy adversely affect physical HRQOL. Feelings of anxiety, depression and treatment side effects have a negative impact on emotional HRQOL.iv

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“…8 Although HP may not be very alternative, it is not mainstream medicine. Given the potential cost-offset, 9 healthcare administrators need to promote integration of HP into the healthcare system. These practitioners reported regular assessment/referral for mental health services, yet there was frustration that patients would decline outside consultation.…”

Section: Physicians' Personal and Practice Use Of Cam Therapies In A mentioning

confidence: 99%

“…Referrals to mental health services outside of medical care often result in lack of treatment. 10 Because integration of psychological services would treat more patients, improve care, and provide cost offset, 9 healthcare should consider more integration of mind-body services, since this artificial separation is outdated and erroneous.…”

Section: Physicians' Personal and Practice Use Of Cam Therapies In A mentioning

confidence: 99%

Physicians' Personal And Practice Use Of Cam Therapies In A Rural Community In The Southeast United States

Martz

Baker

Knott

et al. 2006

The Journal of Alternative and Complementary Medicine

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Behavioral medicine, clinical health psychology, and cost offset.

Cited by 138 publications

References 37 publications

The economics of behavioral health services in medical settings: A summary of the evidence.

The economics of behavioral health services in medical settings: A summary of the evidence.

Social support as a determinant of health-related quality of life in breast cancer survivors in California.

Physicians' Personal And Practice Use Of Cam Therapies In A Rural Community In The Southeast United States

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