The Cost-Effectiveness of Screening Primary Care Patients for Depression

2001 ◽  
Vol 134 (5) ◽  
pp. I-83
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Primary Care Patients ◽  
The Cost

scholarly journals Cost-effectiveness of preventing depression in primary care patients

2006 ◽  
Vol 188 (4) ◽  
pp. 330-336 ◽  
Author(s):  
Filip Smit ◽  
Godelief Willemse ◽  
Marc Koopmanschap ◽  
Simone Onrust ◽  
Pim Cuijpers ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Depressive Disorder ◽  
Usual Care ◽  
Cost Effective ◽  
Randomised Clinical Trial ◽  
Improved Outcomes ◽  
Primary Care Patients ◽  
Minimal Contact ◽  
The Cost

BackgroundLittle is known about the cost-effectiveness of preventing mental disorders.AimsTo study the cost-effectiveness of care as usual plus minimal contact psychotherapy relative to usual care alone in preventing depressive disorder.MethodAn economic evaluation was conducted alongside a randomised clinical trial. Primary care patients with sub-threshold depression were assigned to minimal contact psychotherapy plus usual care (n=107) or to usual care alone (n=109).ResultsPrimary care patients with sub-threshold depression benefited from minimal contact psychotherapy as it reduced the risk of developing a full-blown depressive disorder from 18% to 12%. In addition, this intervention had a 70% probability of being more cost-effective than usual care alone. A sensitivity analysis indicated the robustness of these results.ConclusionsOver 1 year adjunctive minimal contact psychotherapy improved outcomes and generated lower costs. This intervention is therefore superior to usual care alone in terms of cost-effectiveness.

scholarly journals Opportunistic Discovery of Occult Disease by Use of Test Panels in New, Symptomatic Primary Care Outpatients: Yield and Cost of Case Finding

2000 ◽  
Vol 46 (8) ◽  
pp. 1091-1098 ◽  
Author(s):  
Yuzuru Takemura ◽  
Haku Ishida ◽  
Yuji Inoue ◽  
Hiroyuki Kobayashi ◽  
J Robert Beck
Keyword(s):  
Primary Care ◽  
Uric Acid ◽  
Cost Effectiveness ◽  
Disease Patient ◽  
Fecal Occult Blood ◽  
X Rays ◽  
Clinical Efficiency ◽  
National Defense Medical College ◽  
Occult Disease ◽  
The Cost

Abstract Background: Diagnostic test panels have been advocated by the Japan Society of Clinical Pathology for evaluation of presenting complaints of new outpatients in primary care medicine. The tests have additional potential utility for opportunistic finding of asymptomatic diseases, but data are lacking on the number of new conditions identified by the test panels and on the cost per identified case. Methods: We studied 540 new, symptomatic patients at the Comprehensive Medicine Clinics of National Defense Medical College during 1991–1997. All underwent testing with the “Essential Laboratory Tests” panel (2) [ELT(2) panel]. This panel includes hematologic tests, urinalysis, total protein, C-reactive protein, albumin, cholesterol, triglycerides, glucose, urea nitrogen, creatinine, uric acid, serum protein fractionation, six enzymes, and optional tests, including x-rays, electrocardiogram, and fecal occult blood. Results: The ELT(2) panel uncovered 276 additional diagnoses of asymptomatic disease or abnormal health status. The most frequent occult condition was hyperlipidemia (100 cases) followed by liver dysfunction (53 cases). Clinical efficiency of the panel (occult diseases/patient) varied depending on the category of tentative initial diagnosis, with the highest efficiency in patients with cardiovascular disease. We created smaller panels by combining 11 basic tests [called the ELT(1) baseline panel] with one or more additional tests from the ELT(2) and analyzed their cost-effectiveness. Addition of four tests (total cholesterol, alanine aminotransferase, glucose, and uric acid) improved both clinical efficiency (0.41 occult disease/patient) and economic efficiency [¥2372 (∼$22.50 US)/occult disease] at a cost-effectiveness of ¥177 per incremental case of occult disease. Addition of further tests decreased cost-effectiveness. Conclusions: Although the ELT(2) panel has supplemental utility for opportunistic screening of some significant, occult diseases and conditions, universal utilization of the full panel is not supported by the cost-effectiveness found in this study.

scholarly journals The Cost of Hepatitis C Testing Strategies in Primary Care Patients with Abnormal Transaminases

2019 ◽  
Vol 35 (4) ◽  
pp. 1340-1342 ◽  
Author(s):  
Andrew D. Schreiner ◽  
Don C. Rockey ◽  
William P. Moran
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
Testing Strategies ◽  
Primary Care Patients ◽  
The Cost

Incremental cost-effectiveness of a collaborative care intervention for panic disorder

2006 ◽  
Vol 36 (3) ◽  
pp. 353-363 ◽  
Author(s):  
WAYNE KATON ◽  
JOAN RUSSO ◽  
CATHY SHERBOURNE ◽  
MURRAY B. STEIN ◽  
MICHELLE CRASKE ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Panic Disorder ◽  
Incremental Cost ◽  
Usual Care ◽  
Moderate Increase ◽  
Patient Costs ◽  
Care Intervention ◽  
Life Years ◽  
Primary Care Patients

Background. Panic disorder is a prevalent, often disabling, disorder among primary-care patients, but there are large gaps in quality of treatment in primary care. This study describes the incremental cost-effectiveness of a combined cognitive behavioral therapy (CBT) and pharmacotherapy intervention for patients with panic disorder versus usual primary-care treatment.Method. This randomized control trial recruited 232 primary-care patients meeting DSM-IV criteria for panic disorder from March 2000 to March 2002 from six primary-care clinics from university-affiliated clinics at the University of Washington (Seattle) and University of California (Los Angeles and San Diego). Patients were randomly assigned to receive either treatment as usual or a combined CBT and pharmacotherapy intervention for panic disorder delivered in primary care by a mental health therapist. Intervention patients had up to six sessions of CBT modified for the primary-care setting in the first 12 weeks, and up to six telephone follow-ups over the next 9 months. The primary outcome variables were total out-patient costs, anxiety-free days (AFDs) and quality adjusted life-years (QALYs).Results. Relative to usual care, intervention patients experienced 60·4 [95% confidence interval (CI) 42·9–77·9] more AFDs over a 12-month period. Total incremental out-patient costs were $492 higher (95% CI $236–747) in intervention versus usual care patients with a cost per additional AFD of $8.40 (95% CI $2.80–14.0) and a cost per QALY ranging from $14158 (95% CI $6791–21496) to $24776 (95% CI $11885–37618). The cost per QALY estimate is well within the range of other commonly accepted medical interventions such as statin use and treatment of hypertension.Conclusions. The combined CBT and pharmacotherapy intervention was associated with a robust clinical improvement compared to usual care with a moderate increase in ambulatory costs.

scholarly journals Cost-effectiveness of computerized cognitive–behavioural therapy for the treatment of depression in primary care: findings from the Randomised Evaluation of the Effectiveness and Acceptability of Computerised Therapy (REEACT) trial

2017 ◽  
Vol 47 (10) ◽  
pp. 1825-1835 ◽  
Author(s):  
A. Duarte ◽  
S. Walker ◽  
E. Littlewood ◽  
S. Brabyn ◽  
C. Hewitt ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Scenario Analyses ◽  
Cognitive Behavioural ◽  
Life Years ◽  
Gp Care ◽  
The Cost

BackgroundComputerized cognitive–behavioural therapy (cCBT) forms a core component of stepped psychological care for depression. Existing evidence for cCBT has been informed by developer-led trials. This is the first study based on a large independent pragmatic trial to assess the cost-effectiveness of cCBT as an adjunct to usual general practitioner (GP) care compared with usual GP care alone and to establish the differential cost-effectiveness of a free-to-use cCBT programme (MoodGYM) in comparison with a commercial programme (Beating the Blues) in primary care.MethodCosts were estimated from a healthcare perspective and outcomes measured using quality-adjusted life years (QALYs) over 2 years. The incremental cost-effectiveness of each cCBT programme was compared with usual GP care. Uncertainty was estimated using probabilistic sensitivity analysis and scenario analyses were performed to assess the robustness of results.ResultsNeither cCBT programme was found to be cost-effective compared with usual GP care alone. At a £20 000 per QALY threshold, usual GP care alone had the highest probability of being cost-effective (0.55) followed by MoodGYM (0.42) and Beating the Blues (0.04). Usual GP care alone was also the cost-effective intervention in the majority of scenario analyses. However, the magnitude of the differences in costs and QALYs between all groups appeared minor (and non-significant).ConclusionsTechnically supported cCBT programmes do not appear any more cost-effective than usual GP care alone. No cost-effective advantage of the commercially developed cCBT programme was evident compared with the free-to-use cCBT programme. Current UK practice recommendations for cCBT may need to be reconsidered in the light of the results.

scholarly journals The Cost-Effectiveness of a Novel SIAscopic Diagnostic Aid for the Management of Pigmented Skin Lesions in Primary Care: A Decision-Analytic Model

2013 ◽  
Vol 16 (2) ◽  
pp. 356-366 ◽  
Author(s):  
Edward C.F. Wilson ◽  
Jon D. Emery ◽  
Ann Louise Kinmonth ◽  
A. Toby Prevost ◽  
Helen C. Morris ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Skin Lesions ◽  
Decision Analytic Model ◽  
Analytic Model ◽  
Diagnostic Aid ◽  
Pigmented Skin Lesions ◽  
The Cost
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