Impact of deductibles on initiation and continuation of psychotherapy for treatment of depression

Published: February 29, 2012
Category: Bibliography > Papers
Authors: Ding V, Fishman PA, Hubbard R, Ludman EJ, Morales L, Pabiniak C, Simon GE, Stewart C
Countries: United States
Language: null
Types: Population Health
Settings: Academic, Hospital

Health Serv Res 47:1561-1579.

Group Health Research Institute and University of Washington, Seattle, WA, USA

OBJECTIVE: To estimate the impact of deductibles on the initiation and continuation of psychotherapy for depression.

DATA SOURCES/STUDY SETTING: Data from health care encounters and claims from Group Health Cooperative, a large integrated health care system in Washington State, was merged with information from a centralized behavioral health triage call center to conduct study analyses.

STUDY DESIGN: A retrospective observational design using a hierarchical logistic regression model was used to estimate initiation and continuation probabilities for use of psychotherapy, adjusting for key sociodemographic/economic factors and prior use of behavioral health services relevant to individual decisions to seek mental health care.

DATA COLLECTION/EXTRACTION METHODS: Analyses were based on merged datasets on patient enrollment, insurance benefits, use of mental health and general medical services and information collected by a triage specialist at a centralized behavioral health call center.

PRINCIPAL FINDINGS: Among individuals with unmet deductibles between $100 and $500, we found a statistically significant lower likelihood of making an initial visit, but there was no statistically significant effect on making an initial or subsequent visit among individuals that had met their deductible.

CONCLUSIONS: Unmet deductibles appear to influence the likelihood of initiating psychotherapy for treating depression.

PMID: 22375796
PMCID: PMC3371095

High-Impact Chronic Conditions,Resource Use,Practice Patterns Comparison,Payment,United States,Adolescent,Adult,Aged,Gender,Health Services Needs and Demand,Health Services Research,Logistic Models,Middle Aged,Retrospective Studies,Washington

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