Group Health Research Institute and University of Washington, Seattle, WA 98101, USA.
Health Serv Res. 2012 Aug;47(4):1561-79. doi: 10.1111/j.1475-6773.2012.01388.x. Epub 2012 Feb 29.
To estimate the impact of deductibles on the initiation and continuation of psychotherapy for depression.
DATA SOURCES/STUDY SETTING: Data from health care encounters and claims from Group Health Cooperative, a large integrated health care system in Washington State, was merged with information from a centralized behavioral health triage call center to conduct study analyses.
A retrospective observational design using a hierarchical logistic regression model was used to estimate initiation and continuation probabilities for use of psychotherapy, adjusting for key sociodemographic/economic factors and prior use of behavioral health services relevant to individual decisions to seek mental health care.
DATA COLLECTION/EXTRACTION METHODS: Analyses were based on merged datasets on patient enrollment, insurance benefits, use of mental health and general medical services and information collected by a triage specialist at a centralized behavioral health call center.
Among individuals with unmet deductibles between $100 and $500, we found a statistically significant lower likelihood of making an initial visit, but there was no statistically significant effect on making an initial or subsequent visit among individuals that had met their deductible.
Unmet deductibles appear to influence the likelihood of initiating psychotherapy for treating depression.
评估自付额对抑郁症心理治疗开始和持续的影响。
资料来源/研究场所：华盛顿州大型综合医疗保健系统 Group Health Cooperative 的医疗保健就诊和索赔数据与来自集中行为健康分诊呼叫中心的信息合并，以进行研究分析。
使用分层逻辑回归模型进行回顾性观察设计，以估计使用心理治疗的开始和持续概率，调整关键的社会人口经济学因素以及与寻求心理健康护理的个体决策相关的行为健康服务的先前使用情况。
资料收集/提取方法：分析基于患者登记、保险福利、心理健康和一般医疗服务的使用以及集中行为健康呼叫中心的分诊专家收集的信息的合并数据集。
在未达到 100 至 500 美元自付额的个体中，我们发现初始就诊的可能性显著降低，但对于已达到自付额的个体，初始或后续就诊的可能性没有统计学意义。
未达到自付额似乎会影响治疗抑郁症的心理治疗开始的可能性。
