| Authors, Primary | Unutzer J;Katon WJ;Fan MY;Schoenbaum MC;Lin EH;Della Penna RD;Powers D |
| Title Primary | Long-term cost effects of collaborative care for late-life depression |
| Periodical Full | The American Journal of Managed Care |
| Pub Year | 2008 |
| Volume | 14 |
| issue | 2 |
| Start Page | 95-100 |
| Abstract | OBJECTIVE: To determine the long-term effects on total healthcare costs of the Improving Mood: Promoting Access to Collaborative Treatment (IMPACT) program for late-life depression compared with usual care. STUDY DESIGN: Randomized controlled trial with enrollment from July 1999 through August 2001. The IMPACT trial, conducted in primary care practices in 8 delivery organizations across the United States, enrolled 1801 depressed primary care patients 60 years or older. Data are from the 2 IMPACT sites for which 4-year cost data were available. Trial enrollment across these 2 health maintenance organizations was 551 patients. METHODS: Participants were randomly assigned to the IMPACT intervention (n = 279) or to usual primary care (n = 272). Intervention patients had access to a depression care manager who provided education, behavioral activation, support of antidepressant medication management prescribed by their regular primary care provider, and problem-solving treatment in primary care for up to 12 months. Care managers were supervised by a psychiatrist and a primary care provider. The main outcome measures were healthcare costs during 4 years. RESULTS: IMPACT participants had lower mean total healthcare costs ($29 422; 95% confidence interval, $26 479-$32 365) than usual care patients ($32 785; 95% confidence interval, $27 648-$37 921) during 4 years. Results of a bootstrap analysis suggested an 87% probability that the IMPACT program was associated with lower healthcare costs than usual care. CONCLUSION: Compared with usual primary care, the IMPACT program is associated with a high probability of lower total healthcare costs during a 4-year period. |
| Publisher | Not Available |
| Place of Publication | Not Available |
| Author/Address | Not Available |
| PubMed Link | http://www.ncbi.nlm.nih.gov/pubmed/18269305 |
| Reference Type(s) | Journal Article |
| Topic Tag(s) | Comprehensive Care;Care Coordination;Cost and Reimbursement;Outcomes |
| Special Population(s) | People with Mental and Behavioral Health Issues |
| Case Study | No |
| Commentary/Opinion Piece |
| Historical Publication | No |
| Key/Foundational Article | No |
| Literature Review | No |
| Article Rating | No |
| Summary of Article Rating | No |
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