Effect of a Short-term Outpatient Psychiatric Therapy Benefit on the Utilization of Medical Services in a Prepaid Group Practice Medical Program

Economic Incentives for Health

“…Interest in the economic impacts of coverage extends far beyond the desk of the insurance executive and the blackboard of the academic economist: the major national health policy problem of the day is the high and rising cost of health care ; the nature and extent of health coverage are seen as both cause of and potential solution to this problem. Unlike the poorly understood relationship between risk rating and health behavior, there is a wealth of empirical studies relating to the impacts of insurance on the utilization of a wide variety of medical services , including ambulatory care (79,81,88), hospital care (9, 30, 32, 109), dental services (31), and mental health services (40,110) . Concern with the utilization encouraging effect of early-dollar coverage has produced several proposals for catastrophic-coverage national health insurance , dating back well over a de cade (24,29,78).…”

The Prediction of Psychomaintenance in Chronic Asthma

“…Identification of high risk patients allows for the appropriate distribution of psychologic services (typically a scarce resource in medical settings) concomitant with the onset of medical treatment. The efficacy of psychological treatment reported in previous reports [1][2][3][4][5] may be due to the amelioration of the substantial impact of psychomaintenance issues among high risk patients. Via proper use of early identification pro cedures, such as the present Bayesian model, psychologic treatment of med ical patients should prove to be even more efficacious and even more cost effective.…”

“…Over the past few years, several studies [1][2][3][4][5] have begun to document the efficacy of psychologic interventions in reducing the utilization of and need for medical services among the high-risk medical patients. Such find ing raise numerous questions about how psychotherapy benefits the physi cally ill. For example, a careful reading of the above studies fails to enlighten the reader as to what specifically constituted the psychothera peutic techniques employed, how such techniques resulted in therapeutic change, and whether such techniques are equally applicable to every patient.…”

Frequent Users of Rural Primary Care: Comparisons With Randomly Selected Users

“…It is possible that (1) there was a high occurrence of dysthymic disorder among frequent users (dysthymia does not typically respond well to antidepressants); (2) somatization disorder or personality disorders were mistaken for depression (neither of the former respond well to antidepressants); or (3) patients were undermedicated. Medication-resistant depressions could also result in more frequent clinic use for somatic complaints.…”