Center for Health Systems Analysis, PO Box 2045, Fairfield, Iowa 52556, USA.
Am J Health Promot. 2011 Sep-Oct;26(1):56-60. doi: 10.4278/ajhp.100729-ARB-258.
To determine whether the Transcendental Meditation (TM) technique can affect the physician costs of consistently high-cost people.
Quasi-experimental, longitudinal, cost-minimization evaluation. This 14-year, preintervention-postintervention study retrospectively assessed government payments to physicians for treating the TM and no-treatment (NT) groups.
Province of Quebec, Canada.
The highest-spending 10% of 1418 Quebec health insurance enrollees who practiced the TM technique were compared with the highest 10% of 1418 subjects who were randomly selected from enrollees of the same age, sex, and region. TM participants had chosen to begin the technique prior to choosing to enter the study.
Annual payments to private physicians in all treatment settings. The Quebec government health insurance agency provided the total physician payments for each of the 2836 subjects from 1981 to 1994. Other medical expense data for individuals were unavailable. Data were adjusted for medical cost inflation.
For each subject, least-squares regression slopes were calculated to estimate preintervention and postintervention annual rates of change in payments. The groups' means, slopes, and medians were compared using both parametric and nonparametric tests.
Before starting meditation, the yearly rate of increase in payments to physicians between groups was not significantly different. After commencing meditation, the TM group's mean payments declined $44.93 annually (p = .004), whereas the NT comparison group's payments exhibited nonsignificant changes. After 1 year, the TM group decreased 11%, and after 5 years their cumulative reduction was 28% (p = .001).
The results suggest the intervention may be an effective method for reducing physician costs. Randomized studies are recommended.
确定超觉静坐（TM）技术是否会影响高成本人群的医生费用。
准实验、纵向、成本最小化评估。这项为期 14 年的干预前-干预后研究回顾性评估了政府为治疗 TM 组和非治疗（NT）组支付给医生的费用。
加拿大魁北克省。
1418 名魁北克健康保险参保者中，花费最高的 10%的人练习 TM 技术，与随机选择的年龄、性别和地区相同的 1418 名受试者中花费最高的 10%进行比较。TM 参与者在选择参加研究之前选择开始练习该技术。
所有治疗环境下私人医生的年度支付。魁北克政府医疗保险机构提供了 1981 年至 1994 年期间 2836 名受试者的所有医生支付总额。个人的其他医疗费用数据不可用。数据根据医疗费用通胀进行了调整。
为每个受试者计算最小二乘回归斜率，以估计干预前和干预后支付的年度变化率。使用参数和非参数检验比较两组的平均值、斜率和中位数。
在开始冥想之前，两组之间支付给医生的年增长率没有显著差异。开始冥想后，TM 组的平均支付额每年减少 44.93 美元（p = .004），而 NT 对照组的支付额没有明显变化。一年后，TM 组下降了 11%，五年后累计减少了 28%（p = .001）。
结果表明，该干预措施可能是降低医生费用的有效方法。建议进行随机研究。
