TY - JOUR
AU - M. Vukovich
AU - J. Esala
AU - A. Beckman
AU - A. Northwood
AU - G. Vinson
AU - J. Letts
AU - C. Danner
A1 - 
AB - Many refugees experience exposure to chronic and traumatic stressors that can lead to complex mental health and other health care needs. The integration of behavioral health into primary care is a promising approach for addressing complex health needs; however, it has been understudied with refugee and immigrant populations. Using a pragmatic randomized control trial design, this study examined inpatient and outpatient health service utilization and associated costs of a primary care-based intensive psychotherapy and case management intervention for 214 Karen refugees with major depression compared to care as usual over time. Results indicated the addition of the behavioral health intervention was associated with reduced inpatient healthcare costs vs. care as usual, shorter hospital stays, and improved patient status at discharge. The average inpatient cost saving exceeded $8,000 per patient among the intervention group. After controlling for key patient characteristics, patients who received the intervention accrued lower outpatient costs as compared to care as usual over 18 months. Findings suggested the integrated behavioral health intervention resulted in lower healthcare costs among refugees with complex health needs engaged in primary health care. Future research is needed to better understand long-term effects and further optimize care for refugees.Trial Registration clinicaltrials.gov Identifier NCT03788408. Registered 20 Dec 2018. Retrospectively registered.
AD - University of Denver, Denver, USA. Maria.Vukovich@du.edu.; The Center for Victims of Torture, Saint Paul, USA.; Cascade Therapy Group, Minnesota, USA.; Unaffiliated, Wisconsin, USA.; Fairview Health System, Minneapolis, USA.; University of Minnesota, Minneapolis, USA.
AN - 41176745
BT - J Immigr Minor Health
C5 - Financing & Sustainability; Healthcare Disparities
DA - Nov 2
DO - 10.1007/s10903-025-01806-7
DP - NLM
ET - 20251102
JF - J Immigr Minor Health
LA - eng
N2 - Many refugees experience exposure to chronic and traumatic stressors that can lead to complex mental health and other health care needs. The integration of behavioral health into primary care is a promising approach for addressing complex health needs; however, it has been understudied with refugee and immigrant populations. Using a pragmatic randomized control trial design, this study examined inpatient and outpatient health service utilization and associated costs of a primary care-based intensive psychotherapy and case management intervention for 214 Karen refugees with major depression compared to care as usual over time. Results indicated the addition of the behavioral health intervention was associated with reduced inpatient healthcare costs vs. care as usual, shorter hospital stays, and improved patient status at discharge. The average inpatient cost saving exceeded $8,000 per patient among the intervention group. After controlling for key patient characteristics, patients who received the intervention accrued lower outpatient costs as compared to care as usual over 18 months. Findings suggested the integrated behavioral health intervention resulted in lower healthcare costs among refugees with complex health needs engaged in primary health care. Future research is needed to better understand long-term effects and further optimize care for refugees.Trial Registration clinicaltrials.gov Identifier NCT03788408. Registered 20 Dec 2018. Retrospectively registered.
PY - 2025
SN - 1557-1912
ST - Cost Savings from Integrating Behavioral Health in Primary Care: A Pragmatic Randomized Control Trial with Karen Refugees
T1 - Cost Savings from Integrating Behavioral Health in Primary Care: A Pragmatic Randomized Control Trial with Karen Refugees
T2 - J Immigr Minor Health
TI - Cost Savings from Integrating Behavioral Health in Primary Care: A Pragmatic Randomized Control Trial with Karen Refugees
U1 - Financing & Sustainability; Healthcare Disparities
U3 - 10.1007/s10903-025-01806-7
VO - 1557-1912
Y1 - 2025
ER -