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A pilot study of the impact of an integrated individual- and family therapy model for self-harming adolescents on overall healthcare consumption
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala, Sweden.
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden.
Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Respiratory, Allergy- and Sleep Medicine Research Unit, Uppsala University, Uppsala, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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2021 (English)In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 21, no 1, article id 374Article in journal (Refereed) Published
Abstract [en]

Background: Self-harming behaviors in adolescents cause great suffering and can lead to considerable costs to the healthcare system. The aim of the current study was to investigate the cost of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) and to compare the adolescent’s healthcare consumption 1 year before and 1 year after treatment.

Method: The study had a within group design with repeated measures. The clinical outcomes and the cost of ICT treatment are based on a sample of 49 participants who were previously enrolled in an intervention trial. Participants with significantly improved clinical outcomes (self-harm behavior, or general mental health symptoms) were defined as treatment responders. Calculation of changes in healthcare consumption is based on 25 participants who gave their consent to participate in a retrospective collection of healthcare data from medical records, including inpatient and outpatient care, and prescribed medication.

Results: The average estimated cost of ICT per person was €5293. There were no significant differences between the cost of healthcare consumption 1 year before and after ICT, but the results suggested that the adolescents consumed less inpatient and specialized care after treatment. There was a significantly higher cost of psychotropic medication after treatment explained by a higher consumption of central stimulants. Treatment responders (general mental health problems) reduced their consumption of healthcare resources significantly more than non-responders, especially regarding hospital visits and total health care costs.

Conclusions: Good response to the ICT in terms of improved general mental health symptoms seems to be associated with reduced healthcare consumption during the post-treatment period. However, controlled studies with larger sample sizes are needed to draw causal conclusions. The results of this study should be interpreted with caution as it is based on a small sample and attrition rate was high. Trial registration: This study has been registered with the ISRCTN: 15885573.

Place, publisher, year, edition, pages
BioMed Central, 2021. Vol. 21, no 1, article id 374
Keywords [en]
Adolescents, Cost of treatment, Healthcare consumption, Self-harm
National Category
Psychiatry Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:umu:diva-186572DOI: 10.1186/s12888-021-03375-zISI: 000678571100004PubMedID: 34311711Scopus ID: 2-s2.0-85111297885OAI: oai:DiVA.org:umu-186572DiVA, id: diva2:1584533
Funder
Sven Jerring FoundationAvailable from: 2021-08-12 Created: 2021-08-12 Last updated: 2024-01-17Bibliographically approved

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Feldman, Inna

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CiteExportLink to record
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