Reducing the number of emergency department visits and costs associated with anxiety: a randomized controlled study
To demonstrate the economic effects of an intervention for members discharged from the emergency department (ED) with anxiety diagnoses. Randomized controlled study. Adults with commercial, Medicare, or Medicaid insurance coverage enrolled in a health maintenance organization and discharged from an...
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Published in | The American journal of managed care Vol. 13; no. 2; pp. 95 - 102 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
United States
Ascend Media
01.02.2007
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Subjects | |
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Abstract | To demonstrate the economic effects of an intervention for members discharged from the emergency department (ED) with anxiety diagnoses.
Randomized controlled study.
Adults with commercial, Medicare, or Medicaid insurance coverage enrolled in a health maintenance organization and discharged from an ED with anxiety diagnoses were randomly assigned to receive usual care (n = 300) or a stepped-care intervention (n = 307). Psychiatric ED and outpatient visit utilization and cost data identified by claims were collected for 6 months following the initial ED visit.
Members assigned to receive the intervention demonstrated significantly fewer ED visits and lower associated facility costs in the 6 months following discharge compared with those assigned to usual care. No significant differences in psychiatric outpatient visit costs were observed. Members receiving usual care made 117 visits to the ED for a psychiatric condition during the follow-up period, for a mean of 0.39 visits per member and a mean facility cost of 118.15 dollars per member, while members receiving case management services made 79 visits to the ED for a psychiatric condition during the follow-up period, for a mean of 0.26 visits per member and a mean facility cost of 70.63 dollars per member. The intervention resulted in a savings of 7.92 dollars in ED costs per member per month for all psychiatric diagnoses during the 6-month study period.
The case management-based intervention effectively reduced psychiatric ED recidivism and costs for members discharged from the ED with an anxiety diagnosis, without significantly affecting psychiatric outpatient visit costs. |
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AbstractList | OBJECTIVETo demonstrate the economic effects of an intervention for members discharged from the emergency department (ED) with anxiety diagnoses.STUDY DESIGNRandomized controlled study.METHODSAdults with commercial, Medicare, or Medicaid insurance coverage enrolled in a health maintenance organization and discharged from an ED with anxiety diagnoses were randomly assigned to receive usual care (n = 300) or a stepped-care intervention (n = 307). Psychiatric ED and outpatient visit utilization and cost data identified by claims were collected for 6 months following the initial ED visit.RESULTSMembers assigned to receive the intervention demonstrated significantly fewer ED visits and lower associated facility costs in the 6 months following discharge compared with those assigned to usual care. No significant differences in psychiatric outpatient visit costs were observed. Members receiving usual care made 117 visits to the ED for a psychiatric condition during the follow-up period, for a mean of 0.39 visits per member and a mean facility cost of 118.15 dollars per member, while members receiving case management services made 79 visits to the ED for a psychiatric condition during the follow-up period, for a mean of 0.26 visits per member and a mean facility cost of 70.63 dollars per member. The intervention resulted in a savings of 7.92 dollars in ED costs per member per month for all psychiatric diagnoses during the 6-month study period.CONCLUSIONThe case management-based intervention effectively reduced psychiatric ED recidivism and costs for members discharged from the ED with an anxiety diagnosis, without significantly affecting psychiatric outpatient visit costs. To demonstrate the economic effects of an intervention for members discharged from the emergency department (ED) with anxiety diagnoses. Randomized controlled study. Adults with commercial, Medicare, or Medicaid insurance coverage enrolled in a health maintenance organization and discharged from an ED with anxiety diagnoses were randomly assigned to receive usual care (n = 300) or a stepped-care intervention (n = 307). Psychiatric ED and outpatient visit utilization and cost data identified by claims were collected for 6 months following the initial ED visit. Members assigned to receive the intervention demonstrated significantly fewer ED visits and lower associated facility costs in the 6 months following discharge compared with those assigned to usual care. No significant differences in psychiatric outpatient visit costs were observed. Members receiving usual care made 117 visits to the ED for a psychiatric condition during the follow-up period, for a mean of 0.39 visits per member and a mean facility cost of 118.15 dollars per member, while members receiving case management services made 79 visits to the ED for a psychiatric condition during the follow-up period, for a mean of 0.26 visits per member and a mean facility cost of 70.63 dollars per member. The intervention resulted in a savings of 7.92 dollars in ED costs per member per month for all psychiatric diagnoses during the 6-month study period. The case management-based intervention effectively reduced psychiatric ED recidivism and costs for members discharged from the ED with an anxiety diagnosis, without significantly affecting psychiatric outpatient visit costs. |
Audience | Academic |
Author | Futterman, Robert Meyerkopf, Neil Kolbasovsky, Andrew Reich, Leonard |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/17286529$$D View this record in MEDLINE/PubMed |
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Snippet | To demonstrate the economic effects of an intervention for members discharged from the emergency department (ED) with anxiety diagnoses.
Randomized controlled... OBJECTIVETo demonstrate the economic effects of an intervention for members discharged from the emergency department (ED) with anxiety diagnoses.STUDY... |
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SubjectTerms | Adult Anxiety Anxiety Disorders - diagnosis Anxiety Disorders - economics Anxiety Disorders - therapy Care and treatment Case Management - economics Economic aspects Emergency medical services Emergency Service, Hospital - economics Emergency Service, Hospital - utilization Female Health administration Humans Insurance, Health - economics Logistic Models Male Management Medicaid Medicaid - economics Medical care, Cost of Mental Health Services - economics Mental Health Services - utilization Middle Aged Outpatient Clinics, Hospital - economics Outpatient Clinics, Hospital - utilization United States |
Title | Reducing the number of emergency department visits and costs associated with anxiety: a randomized controlled study |
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