Cargando…

Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual

Suicide rates have been steadily increasing in both the U.S. general population and military, with significant psychological and economic consequences. The purpose of the current study was to examine the economic costs and cost-benefit of the suicide-focused Collaborative Assessment and Management o...

Descripción completa

Detalles Bibliográficos
Autores principales: McCutchan, Phoebe K., Yates, Brian T., Jobes, David A., Kerbrat, Amanda H., Comtois, Katherine Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812929/
https://www.ncbi.nlm.nih.gov/pubmed/35113921
http://dx.doi.org/10.1371/journal.pone.0262592
_version_ 1784644761506807808
author McCutchan, Phoebe K.
Yates, Brian T.
Jobes, David A.
Kerbrat, Amanda H.
Comtois, Katherine Anne
author_facet McCutchan, Phoebe K.
Yates, Brian T.
Jobes, David A.
Kerbrat, Amanda H.
Comtois, Katherine Anne
author_sort McCutchan, Phoebe K.
collection PubMed
description Suicide rates have been steadily increasing in both the U.S. general population and military, with significant psychological and economic consequences. The purpose of the current study was to examine the economic costs and cost-benefit of the suicide-focused Collaborative Assessment and Management of Suicidality (CAMS) intervention versus enhanced treatment as usual (ETAU) in an active duty military sample using data from a recent randomized controlled trial of CAMS versus ETAU. The full intent-to-treat sample included 148 participants (mean age 26.8 years ± 5.9 SD years, 80% male, 53% White). Using a micro-costing approach, the cost of each condition was calculated at the individual level from a healthcare system perspective. Benefits were estimated at the individual level as cost savings in past-year healthcare expenditures based on direct care reimbursement rates. Cost-benefit was examined in the form of cost-benefit ratios and net benefit. Total costs, benefits, cost-benefit ratios, and net benefit were calculated and analyzed using general linear mixed modeling on multiply imputed datasets. Results indicated that treatment costs did not differ significantly between conditions; however, CAMS was found to produce significantly greater benefit in the form of decreased healthcare expenditures at 6-month follow-up. CAMS also demonstrated significantly greater cost-benefit ratios (i.e., benefit per dollar spent on treatment) and net-benefit (i.e., total benefit less the cost of treatment) at 12-month follow-up. The current study suggests that beyond its clinical effectiveness, CAMS may also convey potential economic advantages over usual care for the treatment of suicidal active duty service members. Our findings demonstrate cost savings in the form of reduced healthcare expenditures, which theoretically represent resources that can be reallocated toward other healthcare system needs, and thus lend support toward the overall value of CAMS.
format Online
Article
Text
id pubmed-8812929
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-88129292022-02-04 Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual McCutchan, Phoebe K. Yates, Brian T. Jobes, David A. Kerbrat, Amanda H. Comtois, Katherine Anne PLoS One Research Article Suicide rates have been steadily increasing in both the U.S. general population and military, with significant psychological and economic consequences. The purpose of the current study was to examine the economic costs and cost-benefit of the suicide-focused Collaborative Assessment and Management of Suicidality (CAMS) intervention versus enhanced treatment as usual (ETAU) in an active duty military sample using data from a recent randomized controlled trial of CAMS versus ETAU. The full intent-to-treat sample included 148 participants (mean age 26.8 years ± 5.9 SD years, 80% male, 53% White). Using a micro-costing approach, the cost of each condition was calculated at the individual level from a healthcare system perspective. Benefits were estimated at the individual level as cost savings in past-year healthcare expenditures based on direct care reimbursement rates. Cost-benefit was examined in the form of cost-benefit ratios and net benefit. Total costs, benefits, cost-benefit ratios, and net benefit were calculated and analyzed using general linear mixed modeling on multiply imputed datasets. Results indicated that treatment costs did not differ significantly between conditions; however, CAMS was found to produce significantly greater benefit in the form of decreased healthcare expenditures at 6-month follow-up. CAMS also demonstrated significantly greater cost-benefit ratios (i.e., benefit per dollar spent on treatment) and net-benefit (i.e., total benefit less the cost of treatment) at 12-month follow-up. The current study suggests that beyond its clinical effectiveness, CAMS may also convey potential economic advantages over usual care for the treatment of suicidal active duty service members. Our findings demonstrate cost savings in the form of reduced healthcare expenditures, which theoretically represent resources that can be reallocated toward other healthcare system needs, and thus lend support toward the overall value of CAMS. Public Library of Science 2022-02-03 /pmc/articles/PMC8812929/ /pubmed/35113921 http://dx.doi.org/10.1371/journal.pone.0262592 Text en © 2022 McCutchan et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
McCutchan, Phoebe K.
Yates, Brian T.
Jobes, David A.
Kerbrat, Amanda H.
Comtois, Katherine Anne
Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual
title Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual
title_full Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual
title_fullStr Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual
title_full_unstemmed Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual
title_short Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual
title_sort costs, benefits, and cost-benefit of collaborative assessment and management of suicidality versus enhanced treatment as usual
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812929/
https://www.ncbi.nlm.nih.gov/pubmed/35113921
http://dx.doi.org/10.1371/journal.pone.0262592
work_keys_str_mv AT mccutchanphoebek costsbenefitsandcostbenefitofcollaborativeassessmentandmanagementofsuicidalityversusenhancedtreatmentasusual
AT yatesbriant costsbenefitsandcostbenefitofcollaborativeassessmentandmanagementofsuicidalityversusenhancedtreatmentasusual
AT jobesdavida costsbenefitsandcostbenefitofcollaborativeassessmentandmanagementofsuicidalityversusenhancedtreatmentasusual
AT kerbratamandah costsbenefitsandcostbenefitofcollaborativeassessmentandmanagementofsuicidalityversusenhancedtreatmentasusual
AT comtoiskatherineanne costsbenefitsandcostbenefitofcollaborativeassessmentandmanagementofsuicidalityversusenhancedtreatmentasusual