Abstract
BackgroundSelf-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.MethodThe 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.ResultsThe 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.ConclusionsGood 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 registrationThis study has been registered with the ISRCTN: 15885573.
Highlights
Self -harm is an important public health concern
There were no significant differences between the cost of healthcare consumption 1 year before and after intensive contextual therapy (ICT), but the results suggested that the adolescents consumed less inpatient and specialized care after treatment
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
Summary
Self -harm is an important public health concern. It is a common and potentially life-threatening behavior [1, 2]. In the UK for example, an estimation from a large register of people admitted to general hospital as a consequence of self-harm, showed that the average healthcare cost for each episode was about £809 [9]. Another study showed that the overall healthcare costs per patient were significantly higher in a six-months period around an episode of self-harm [2]. The healthcare costs increased exponentially in relation to increasing episodes of self-harm and the expenses were mainly attributed to inpatient psychiatric care and psychotropic medication [2]. 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
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