TY - JOUR
KW - Anxiety Disorders/psychology
KW - Child
KW - Cognitive Behavioral Therapy/methods
KW - Cost-Benefit Analysis/methods
KW - Female
KW - Humans
KW - Male
KW - Treatment Outcome
AU - C. E. Yeguez
AU - T. F. Page
AU - Y. Rey
AU - W. K. Silverman
AU - J. W. Pettit
A1 - 
AB - To address the high demand for youth anxiety treatment, researchers have begun to evaluate stepped care approaches to use limited resources efficiently. Quantifying cost savings can inform policy decisions about optimal ways to use limited resources. This study presents a cost analysis of a stepped care treatment approach for anxiety disorders in youth. Youths (N = 112) completed an 8-session computer-administered attention bias modification treatment (Step 1), and families were given the option to "step up" to cognitive behavioral therapy (CBT; Step 2). Stepped care treatment cost estimates were based on (a) resources used in treatment (i.e., clinician/paraprofessional time, equipment/materials) and (b) Medicaid reimbursement rates for clinician and paraprofessional time. We compared these two cost estimates with a hypothetical standard treatment approach for youth anxiety disorders: CBT only. We also tested predictive models to determine whether they could guide decisions about which youths, based on baseline characteristics, should be assigned to stepped care or directly to CBT only to avoid the costs associated with Step 1. Compared to a hypothetical standard CBT approach, the stepped care treatment was associated with an overall cost savings of 44.4% for the Medicaid reimbursement model and 47.7% for the resource cost model. The predictive models indicated that assigning all youths to stepped care would be more cost-effective than assigning certain youths directly to CBT only. This study provides the first evidence that a stepped care treatment approach for youth anxiety is associated with substantial cost savings compared with a standard CBT.
AD - Department of Psychology, Florida International University.; Department of Health Policy and Management, Florida International University.; Department of Psychology, Florida International University.; Child Study Center, Yale University.; Department of Health Policy and Management, Florida International University.
BT - Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
C5 - Financing & Sustainability; Healthcare Disparities
CP - 4
DO - 10.1080/15374416.2018.1539913
IS - 4
JF - Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
LA - eng
M1 - Journal Article
N2 - To address the high demand for youth anxiety treatment, researchers have begun to evaluate stepped care approaches to use limited resources efficiently. Quantifying cost savings can inform policy decisions about optimal ways to use limited resources. This study presents a cost analysis of a stepped care treatment approach for anxiety disorders in youth. Youths (N = 112) completed an 8-session computer-administered attention bias modification treatment (Step 1), and families were given the option to "step up" to cognitive behavioral therapy (CBT; Step 2). Stepped care treatment cost estimates were based on (a) resources used in treatment (i.e., clinician/paraprofessional time, equipment/materials) and (b) Medicaid reimbursement rates for clinician and paraprofessional time. We compared these two cost estimates with a hypothetical standard treatment approach for youth anxiety disorders: CBT only. We also tested predictive models to determine whether they could guide decisions about which youths, based on baseline characteristics, should be assigned to stepped care or directly to CBT only to avoid the costs associated with Step 1. Compared to a hypothetical standard CBT approach, the stepped care treatment was associated with an overall cost savings of 44.4% for the Medicaid reimbursement model and 47.7% for the resource cost model. The predictive models indicated that assigning all youths to stepped care would be more cost-effective than assigning certain youths directly to CBT only. This study provides the first evidence that a stepped care treatment approach for youth anxiety is associated with substantial cost savings compared with a standard CBT.
PY - 2020
SN - 1537-4424; 1537-4416; 1537-4416
SP - 549
EP - 555
EP - 
T1 - A Cost Analysis of a Stepped Care Treatment Approach for Anxiety Disorders in Youth
T2 - Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
TI - A Cost Analysis of a Stepped Care Treatment Approach for Anxiety Disorders in Youth
U1 - Financing & Sustainability; Healthcare Disparities
U2 - 30644757
U3 - 10.1080/15374416.2018.1539913
VL - 49
VO - 1537-4424; 1537-4416; 1537-4416
Y1 - 2020
Y2 - Jul-Aug
ER -