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  1. Are psychiatrists cost-effective ? An analysis of integrated versus split treatment.

    Article, Communication - En anglais

    Annual meeting of the American Psychiatric Association. San Diego, USA, 1997/05/17.

    Objective 

    Managed care organizations prefer putatively less expensive split treatment, i.e., a psychopharmacologist plus a non-M.D. psychotherapist.

    In this study the cost of integrated care by a psychiatrist was compared with split care.

    Method 

    Using 1998 fee schedules of seven large managed care organizations (with 54.3% market share and 67.8 million lives) plus Medicare (37 million people), the author modeled clinical scenarios of psychotherapy alone, medication alone, and combined treatment provided by a psychiatrist or split with a psychologist or social worker.

    Results 

    Brief psychotherapy by a social worker was the least expensive treatment.

    When treatment required both psychotherapy and medication, combined treatment by a psychiatrist cost about the same or less than split treatment with a social worker psychotherapist ; it was usually less expensive than split treatment with a psychologist psychotherapist.

    Conclusions 

    The integrated biopsychosocial model practiced by psychiatry is both theoretically and economically the preferred model when combined treatment is needed.

    Mots-clés Pascal : Trouble psychiatrique, Soin intégré, Traitement associé, Psychothérapie, Chimiothérapie, Personnel sanitaire, Soin, Psychiatre, Etude comparative, Psychologue clinicien, Travailleur social, Analyse coût, Système santé, Etats Unis, Amérique du Nord, Amérique, Santé mentale, Homme, Economie santé, Dispensation soin

    Mots-clés Pascal anglais : Mental disorder, Managed care, Combined treatment, Psychotherapy, Chemotherapy, Health staff, Care, Psychiatrist, Comparative study, Clinicien psychologist, Social worker, Cost analysis, Health system, United States, North America, America, Mental health, Human, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0123526

    Code Inist : 002B18H05B. Création : 16/11/1999.