TY - JOUR
KW - Absenteeism
KW - Adult
KW - Antidepressive Agents/economics/therapeutic use
KW - Cognitive Therapy/economics
KW - Cost-Benefit Analysis/statistics & numerical data
KW - Drug Costs/statistics & numerical data
KW - Female
KW - Follow-Up Studies
KW - Health Care Costs/statistics & numerical data
KW - Health Maintenance Organizations/economics
KW - Humans
KW - Male
KW - Michigan
KW - Middle Aged
KW - Nurse Practitioners/economics
KW - Primary Health Care/economics
KW - Somatoform Disorders/economics
AU - Z. Luo
AU - J. Goddeeris
AU - J. C. Gardiner
AU - R. C. Smith
A1 - 
AB - OBJECTIVE: This study sought to determine whether an intervention for patients with medically unexplained symptoms in primary care reduced total costs, components of cost, and longer-term costs and whether it led to decreased service use outside the health maintenance organization (HMO). METHODS: A randomized controlled trial involving 206 patients with medically unexplained symptoms was conducted in a staff-model HMO. The protocol emphasized the provider-patient relationship and included cognitive-behavioral therapy and pharmacological management. Cost data for medical treatments were derived from the HMO's electronic database. Patients were interviewed about work days lost and out-of-pocket expenses for medical care outside the HMO. RESULTS: The difference in total costs ($1,071) for the 12-month intervention was not significant. The treatment group had significantly higher costs for antidepressants than the usual-care group ($192 higher) during the intervention, and a larger proportion received antidepressants. The intervention group used less medical care outside the HMO and missed one less work day per month on average (1.23 days), indicating a slight improvement in productivity, but the difference was not significant. The between-group difference in estimated total cost was smaller in the year after the intervention (difference of $341) but were not significant. CONCLUSIONS: The total costs for the intervention group were not significantly different, but the group had greater use of antidepressants. Coupled with findings of improved mental health outcomes for this group in a previous study, the results indicate that the intervention may be cost-effective. The longer-term impact needs to be further studied.
BT - Psychiatric services (Washington, D.C.)
C5 - Financing & Sustainability; Medically Unexplained Symptoms
CP - 8
CY - United States
DO - 10.1176/appi.ps.58.8.1079
IS - 8
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: This study sought to determine whether an intervention for patients with medically unexplained symptoms in primary care reduced total costs, components of cost, and longer-term costs and whether it led to decreased service use outside the health maintenance organization (HMO). METHODS: A randomized controlled trial involving 206 patients with medically unexplained symptoms was conducted in a staff-model HMO. The protocol emphasized the provider-patient relationship and included cognitive-behavioral therapy and pharmacological management. Cost data for medical treatments were derived from the HMO's electronic database. Patients were interviewed about work days lost and out-of-pocket expenses for medical care outside the HMO. RESULTS: The difference in total costs ($1,071) for the 12-month intervention was not significant. The treatment group had significantly higher costs for antidepressants than the usual-care group ($192 higher) during the intervention, and a larger proportion received antidepressants. The intervention group used less medical care outside the HMO and missed one less work day per month on average (1.23 days), indicating a slight improvement in productivity, but the difference was not significant. The between-group difference in estimated total cost was smaller in the year after the intervention (difference of $341) but were not significant. CONCLUSIONS: The total costs for the intervention group were not significantly different, but the group had greater use of antidepressants. Coupled with findings of improved mental health outcomes for this group in a previous study, the results indicate that the intervention may be cost-effective. The longer-term impact needs to be further studied.
PP - United States
PY - 2007
SN - 1075-2730; 1075-2730
SP - 1079
EP - 1086
EP - 
T1 - Costs of an intervention for primary care patients with medically unexplained symptoms: a randomized controlled trial
T2 - Psychiatric services (Washington, D.C.)
TI - Costs of an intervention for primary care patients with medically unexplained symptoms: a randomized controlled trial
U1 - Financing & Sustainability; Medically Unexplained Symptoms
U2 - 17664519
U3 - 10.1176/appi.ps.58.8.1079
VL - 58
VO - 1075-2730; 1075-2730
Y1 - 2007
ER -