Lo Sasso Anthony T, Lindrooth Richard C, Lurie Ithai Z, Lyons John S
Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
Med Care. 2006 Apr;44(4):366-72. doi: 10.1097/01.mlr.0000204083.55544.f8.
The justification for higher cost-sharing for behavioral health treatment is its greater price sensitivity relative to general healthcare treatment. Despite this, recent policy efforts have focused on improving access to behavioral health treatment.
We measured the effects on outpatient treatment of depression of a change in mental health benefits for employees of a large U.S.-based corporation.
The benefit change involved 3 major elements: reduced copayments for mental health treatment, the implementation of a selective contracting network, and an effort to destigmatize mental illness. Claims data and a difference-in-differences methodology were used to examine how the benefit change affected outpatient treatment of depression.
Subjects consisted of 214,517 employee-years of data for individuals who were continuously enrolled for at least 1 full year at the intervention company and 96,365 employee-years in the control group.
We measured initiation into treatment of depression and the number of outpatient therapy visits.
The benefit change was associated with a 26% increase in the probability of initiating depression treatment. Conditional on initiating treatment, patients in the intervention company received 1.2 additional (P < 0.001) outpatient mental health treatment visits relative to the control group.
Our results suggest that the overall effect of the company's benefit change was to significantly increase the number of outpatient visits per episode of treatment conditional on treatment initiation.
行为健康治疗采用更高成本分担的理由是，相较于一般医疗保健治疗，其价格敏感性更高。尽管如此，近期的政策努力一直聚焦于改善行为健康治疗的可及性。
我们评估了一家美国大型公司员工心理健康福利变化对抑郁症门诊治疗的影响。
福利变化涉及三个主要方面：降低心理健康治疗的自付费用、实施选择性签约网络以及努力消除对精神疾病的污名化。使用索赔数据和差异比较方法来研究福利变化如何影响抑郁症的门诊治疗。
研究对象包括在干预公司连续登记至少一整年的214,517人年的员工数据，以及对照组的96,365人年的员工数据。
我们测量了抑郁症治疗的起始情况以及门诊治疗就诊次数。
福利变化与抑郁症治疗起始概率增加26%相关。在开始治疗的条件下，干预公司的患者相对于对照组多接受了1.2次（P < 0.001）门诊心理健康治疗就诊。
我们的结果表明，公司福利变化的总体效果是在治疗开始的条件下，显著增加了每次治疗发作的门诊就诊次数。
