Mental Health/Medical Care Cost Offsets: Opportunities For Managed Care

Olfson, Mark; Sing, Merrile; Schlesinger, Herbert J.

doi:10.1377/hlthaff.18.2.79

Cited by 40 publications

(23 citation statements)

References 26 publications

(15 reference statements)

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“…Also other subgroups of costs (inpatient and outpatient) increased, but changes did not reach statistical significance due to low sample size. This finding is in line with studies cited in a review of Olfson and colleagues showing that improved access to adequate services may increase treatment costs of people with severe mental illness (19). Reasons for this are numerous, including heightened awareness of appropriate treatment options in the community through recommendations of key workers or other patients during inpatient treatment.…”

Section: Change Of Costs Over Timesupporting

confidence: 83%

“…This raises the question whether inpatient psychiatric treatment affects service utilization costs after discharge in the sense of the so-called cost-offset effect. Cost-offset suggests that the cost of inpatient treatment may be offset by a reduction in future general medical use and health care costs (19,20). Findings on cost-offset in mental health care are heterogeneous.…”

Section: Introductionmentioning

confidence: 99%

“…Also some other studies have reported a cost reduction after inpatient psychiatric treatment (25,26). However, it has also been argued that cost-offsets are unlikely in the treatment of people with severe mental illness, and that these patients may become more costly when they have more and adequate access to medical services (19,27). In sum, little is known about course of health care costs before and after inpatient mental health care, and whether cost changes over time are affected by source of cost data and patient characteristics.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Course of health care costs before and after psychiatric inpatient treatment: patient-reported vs. administrative records

Zentner

Baumgartner

Becker

et al. 2015

Int J Health Policy Manag

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Background: There is limited evidence on the course of health service costs before and after psychiatric inpatient treatment, which might also be affected by source of cost data. Thus, this study examines: i) differences in health care costs before and after psychiatric inpatient treatment, ii) whether these differences vary by source of cost-data (self-report vs. administrative), and iii) predictors of cost differences over time. Methods: Sixty-one psychiatric inpatients gave informed consent to their statutory health insurance company to provide insurance records and completed assessments at admission and 6-month follow-up. These were compared to the self-reported treatment costs derived from the "Client Socio-demographic and Service Use Inventory" (CSSRI-EU) for two 6-month observation periods before and after admission to inpatient treatment to a large psychiatric hospital in rural Bavaria. Costs were divided into subtypes including costs for inpatient and outpatient treatment as well as for medication. Results: Sixty-one participants completed both assessments. Over one year, the average patient-reported total monthly treatment costs increased from € 276.91 to € 517.88 (paired Wilcoxon Z = -2.27; P = 0.023). Also all subtypes of treatment costs increased according to both data sources. Predictors of changes in costs were duration of the index admission and marital status. Conclusion: Self-reported costs of people with severe mental illness adequately reflect actual service use as recorded in administrative data. The increase in health service use after inpatient treatment can be seen as positive, while the pre-inpatient level of care is a potential problem, raising the question whether more or better outpatient care might have prevented hospital admission. Findings may serve as a basis for future studies aiming at furthering the understanding of what to expect regarding appropriate levels of posthospital care, and what factors may help or inhibit post-discharge treatment engagement. Future research is also needed to examine long-term effects of inpatient psychiatric treatment on outcome and costs. Keywords: Health Service Costs, Administrative Data, Self-Report, Mental Health Services Copyright: © 2015 by Kerman University of Medical Sciences Citation: Zentner N, Baumgartner I, Becker T, Puschner B. Course of health care costs before and after psychiatric inpatient treatment: patient-reported vs. administrative records.

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Section: Change Of Costs Over Timesupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Course of health care costs before and after psychiatric inpatient treatment: patient-reported vs. administrative records

Zentner

Baumgartner

Becker

et al. 2015

Int J Health Policy Manag

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“…England (1999), for example, claims that employers lost $24 billion in 1993 owing to lost work time and productivity as a result of untreated depression among their employees. Olfson, Sing, and Schlesinger (1999) note that the indirect cost savings that occur when mental illness is covered by insurance might be particularly important with respect to treatments for alcoholism. They cite evidence that early treatment of the disorder can eliminate many of the health costs that are associated with alcoholism, such as cirrhosis, cardiomyopathy, and chronic hepatic encephalopathy.…”

Section: Mental Health Parity Backgroundmentioning

confidence: 99%

Subsidizing Addiction: Do State Health Insurance Mandates Increase Alcohol Consumption

Klick

Stratmann

2003

SSRN Journal

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A model of addiction in which individuals are forward looking implies that as the availability of addiction treatment options grows, individuals will consume more of an addictive good.We test this implication using cross-state variation in the adoption of mental health parity mandates that include substance abuse treatments. We examine the effects of these mandates on the consumption of alcohol and find that parity legislation leads to an increase in alcohol consumption. To account for the possible endogeneity of the adoption of mental health parity mandates, we perform an instrumental variables analysis and find that the ordinary least squares estimation significantly underestimates the insurance effect on alcohol consumption.

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“…Identifying mental health problems in primary care might reduce primary care utilization when mental health issues are co-morbid with, or are misidentified as, medical problems 17,18,19. Alternatively, addressing previously undisclosed or untreated mental health problems could increase the number of primary care visits, their length and complexity, or the amount of provider work (e.g.…”

Section: Introductionmentioning

confidence: 99%

Training Clinicians in Mental Health Communication Skills: Impact on Primary Care Utilization

Gadomski

Wissow

Slade³

et al. 2010

Academic Pediatrics

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Objective-Although it is known that children with mental health problems utilize primary care services more than most other children, it is unknown how addressing mental health problems in primary care affects children's subsequent services utilization. This study measures primary care utilization in the context of a randomized trial of a communication skills training program for primary care clinicians that had a positive impact on child mental health outcomes.

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Mental Health/Medical Care Cost Offsets: Opportunities For Managed Care

Cited by 40 publications

References 26 publications

Course of health care costs before and after psychiatric inpatient treatment: patient-reported vs. administrative records

Course of health care costs before and after psychiatric inpatient treatment: patient-reported vs. administrative records

Subsidizing Addiction: Do State Health Insurance Mandates Increase Alcohol Consumption

Training Clinicians in Mental Health Communication Skills: Impact on Primary Care Utilization

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