INTRODUCTION
METHODS
Sample
Intervention
ASSESSMENT OF COSTS AND EFFECTS
Data Collection
Costs
Questionnaire of Service Utilization and Costs
Unit Costs
Sector | Service/goods | Units | Monetary values (unit costs) |
---|---|---|---|
Inpatient services | General hospitals, psychiatric hospitals and hospitals for rehabilitation | Days | Type specific mean rates20 |
Outpatient physician services | GP, psychiatrist, other specialist | Contacts | Type specific mean rates20 |
Outpatient psychotherapist services | Psychotherapist | Contacts | Reimbursement schedule20 |
Medication | Product | Quantity | Official pharmaceutical index (Rote Liste)21 |
Home care | Professional ambulatory care | Hours | Type specific wage20 |
Informal care | Hours | Type specific wage (replacement cost approach)20 | |
Indirect costs | Productivity losses | Hours | Gross income plus non-wage labour costs22 |
Intervention Costs
Effects
Statistical Analysis
Primary Analysis
Supplementary Analyses
RESULTS
Baseline Characteristics of the Study Population
Characteristic | Intervention group (n = 230) | Control group (n = 189) | p value |
---|---|---|---|
Age (years) | |||
Mean (SE) | 46.09 (0.93) | 46.25 (1.07) | 0.91 |
Female: % | 72.17 | 76.72 | 0.29 |
Single: % | 37.39 | 39.68 | 0.63 |
Cohibitants | |||
Mean (SE) | 2.52 (0.08) | 2.33 (0.08) | |
Education (years) | |||
Mean (SE) | 11.20 (0.22) | 10.87 (0.18) | 0.25 |
Employed: % | 63.26 | 57.51 | 0.26 |
Retired: % | 15.11 | 25.40 | 0.01 |
Severity of anxiety (BAI) | |||
Mean (SE) | 28.22 (0.83) | 28.20 (0.92) | 0.98 |
Total costs (€) | |||
Mean (SE) | 6021.34 (692.34) | 4275.66 (471.68) | 0.04 |
EQ-5D Index | |||
Mean (SE) | 0.568 (0.019) | 0.619 (0.020) | 0.07 |
Comorbidities: % | |||
Pulmonary diseases | 13.48 | 15.34 | 0.59 |
Joint diseases | 15.22 | 8.99 | 0.05 |
Intestinal diseases | 24.35 | 20.11 | 0.30 |
Cardiovascular diseases | 37.39 | 39.15 | 0.71 |
Depression | 26.09 | 17.99 | 0.05 |
Somatic symptom disorder | 11.30 | 6.35 | 0.07 |
Primary Analysis
Comparison of Costs and Effects
Category | Intervention group (n = 230) | Control group (n = 189) | ||
---|---|---|---|---|
Mean | SE | Mean | SE | |
Direct costs | 4369.43 | 514.16 | 4239.46 | 568.69 |
Inpatient services | 1993.82 | 361.40 | 2208.98 | 449.34 |
Psychiatric hospital | 653.85 | 264.20 | 837.16 | 324.70 |
Outpatient services | 854.91 | 74.34 | 776.03 | 62.29 |
Psychiatrist | 42.29 | 8.47 | 45.24 | 8.87 |
Psychotherapist | 358.46 | 63.95 | 311.64 | 52.09 |
Medication | 508.46 | 71.85 | 643.69 | 134.51 |
Psychopharmaceuticals | 186.94 | 26.09 | 150.17 | 20.80 |
Professional care | 20.79 | 11.87 | 2.63 | 3.44 |
Informal care | 728.54 | 207.68 | 608.14 | 180.05 |
Intervention* | 262.91 | 8.05 | 0 | 0 |
Indirect costs | 3930.64 | 652.86 | 3637.65 | 567.67 |
Total costs | 8300.07 | 906.27 | 7877.11 | 958.78 |
Total mental health costs | 1504.45 | 279.07 | 1344.21 | 339.62 |
QALY | 0.675 | 0.015 | 0.665 | 0.016 |
Category | 95% confidence interval | ||||
---|---|---|---|---|---|
Mean | SE | Lower limit | Upper limit | p value | |
Direct costs | − 679.93 | 710.28 | −2072.09 | 712.22 | 0.34 |
Inpatient services | − 618.32 | 581.94 | − 1758.94 | 522.29 | 0.29 |
Psychiatric hospital | − 365.06 | 417.85 | − 1184.03 | 453.92 | 0.38 |
Outpatient services | − 66.39 | 89.04 | − 240.91 | 108.13 | 0.46 |
Psychiatrist | − 12.93 | 11.78 | − 36.03 | 11.16 | 0.27 |
Psychotherapist | − 71.41 | 78.47 | − 225.21 | 82.39 | 0.36 |
Medication | − 64.41 | 83.30 | − 227.69 | 98.86 | 0.44 |
Psychopharmaceuticals | 22.83 | 26.77 | − 29.64 | 75.29 | 0.39 |
Informal care | − 5.28 | 248.46 | − 492.25 | 481.70 | 0.98 |
Intervention* | 254.64 | 10.81 | 233.45 | 275.83 | < 0.01 |
Indirect costs | − 369.29 | 716.76 | − 1774.14 | 1035.56 | 0.60 |
Total costs | − 1017.04 | 1168.01 | − 3306.33 | 1272.26 | 0.38 |
Total mental health costs | − 156.93 | 436.08 | − 1011.65 | 697.78 | 0.72 |
QALY* | 0.034 | 0.015 | 0.005 | 0.062 | 0.02 |