TY - JOUR
KW - Cost-Benefit Analysis
KW - Depressive Disorder/economics/therapy
KW - Female
KW - Health Care Costs/statistics & numerical data
KW - Hospitals, Veterans/economics/statistics & numerical data
KW - Humans
KW - Male
KW - Mental Health Services/organization & administration
KW - Middle Aged
KW - Patient Care Team/organization & administration
KW - Primary Health Care/economics/statistics & numerical data
KW - Veterans/psychology
KW - Washington
AU - C. F. Liu
AU - S. C. Hedrick
AU - E. F. Chaney
AU - P. Heagerty
AU - B. Felker
AU - N. Hasenberg
AU - S. Fihn
AU - W. Katon
A1 - 
AB - OBJECTIVE: This study examined the incremental cost-effectiveness of a collaborative care intervention for depression compared with consult-liaison care. METHODS: A total of 354 patients in a Department of Veterans Affairs (VA) primary care clinic who met the criteria for major depression or dysthymia were randomly assigned to one of the two care models. Under the collaborative care model, a mental health team provided a treatment plan to primary care providers, telephoned patients to encourage adherence, reviewed treatment results, and suggested modifications. Outcomes were assessed at three and nine months by telephone interviews. Health care use and costs were also assessed. RESULTS: A significantly greater number of collaborative care patients were treated for depression and given prescriptions for antidepressants. The collaborative care patients experienced an average of 14.6 additional depression-free days over the nine months. The mean incremental cost of the intervention per patient was $237 US dollars for depression treatment and $519 US dollars for total outpatient costs. A majority of the additional expenditures were accounted for by the intervention. The incremental cost-effectiveness ratio was $24 US dollars per depression-free day for depression treatment costs and $33 US dollars for total outpatient cost. CONCLUSIONS: Better coordination and communication under collaborative care was associated with a greater number of patients being treated for depression and with moderate increases in days free of depression and in treatment cost. Additional resources are needed for effective collaborative care models for depression treatment in primary care.
BT - Psychiatric services (Washington, D.C.)
C5 - Financing & Sustainability
CP - 5
CY - United States
IS - 5
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: This study examined the incremental cost-effectiveness of a collaborative care intervention for depression compared with consult-liaison care. METHODS: A total of 354 patients in a Department of Veterans Affairs (VA) primary care clinic who met the criteria for major depression or dysthymia were randomly assigned to one of the two care models. Under the collaborative care model, a mental health team provided a treatment plan to primary care providers, telephoned patients to encourage adherence, reviewed treatment results, and suggested modifications. Outcomes were assessed at three and nine months by telephone interviews. Health care use and costs were also assessed. RESULTS: A significantly greater number of collaborative care patients were treated for depression and given prescriptions for antidepressants. The collaborative care patients experienced an average of 14.6 additional depression-free days over the nine months. The mean incremental cost of the intervention per patient was $237 US dollars for depression treatment and $519 US dollars for total outpatient costs. A majority of the additional expenditures were accounted for by the intervention. The incremental cost-effectiveness ratio was $24 US dollars per depression-free day for depression treatment costs and $33 US dollars for total outpatient cost. CONCLUSIONS: Better coordination and communication under collaborative care was associated with a greater number of patients being treated for depression and with moderate increases in days free of depression and in treatment cost. Additional resources are needed for effective collaborative care models for depression treatment in primary care.
PP - United States
PY - 2003
SN - 1075-2730; 1075-2730
SP - 698
EP - 704
EP - 
T1 - Cost-effectiveness of collaborative care for depression in a primary care veteran population
T2 - Psychiatric services (Washington, D.C.)
TI - Cost-effectiveness of collaborative care for depression in a primary care veteran population
U1 - Financing & Sustainability
U2 - 12719501
VL - 54
VO - 1075-2730; 1075-2730
Y1 - 2003
ER -