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A Reduction in Health Care Expenditures Linked to Mental Health Service Use Among Adults With Chronic Physical Conditions.

Bui LN, Yoon J, Hynes DM. A Reduction in Health Care Expenditures Linked to Mental Health Service Use Among Adults With Chronic Physical Conditions. Psychiatric services (Washington, D.C.). 2021 Jul 1; 72(7):766-775.

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OBJECTIVE: The aim was to examine the impact of receipt of mental health services on health care expenditures for U.S. adults with major chronic physical conditions. METHODS: Medical Expenditure Panel Survey data for 2004-2014 were analyzed for adults ages = 18 with at least one of six chronic physical conditions (cardiovascular diseases, cancer, diabetes, emphysema, asthma, and arthritis) who were followed up for 2 years (N = 33,419). Outcomes included overall health care spending and expenditure by service type (inpatient services, outpatient services, emergency department visits, office-based physician visits, and prescribed medication). A difference-in-differences model compared a change in health care costs in the subsequent year for those who did and did not receive mental health services in the preceding year. RESULTS: On average, the increase in overall health care expenditure in the subsequent year among adults receiving mental health services in the preceding year was smaller by 12.6 percentage points (p < 0.05) than for those who did not receive such services. The difference was equivalent to $1,146 in 2014 constant U.S. dollars (p = 0.05). Medication treatment alone did not have a meaningful effect on overall costs. The combination of psychotherapy and medication was associated with a per-capita reduction in overall health care expenditure of 21.7 percentage points, or $2,690 (p < 0.01). The combination was also associated with reduced costs for office-based visits (p < 0.05) and medication (p < 0.05). CONCLUSIONS: Receipt of mental health services was associated with a reduction in overall health care costs, particularly for office-based visits and prescribed medication, among adults with chronic physical conditions.

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