Mental Health Program Cuts Hospital Costs by Shifting Care to Family Doctors
A new study shows that a psychosocial health promotion program reduced psychiatric and physical healthcare spending while increasing primary care visits—suggesting a more cost-effective care model for people with severe mental illness. The findings could reshape how health systems allocate resources and budget for mental health services.
Originaltitel: Resource Utilization in Severe Mental Illness (SMI) Before, During and After a Psychosocial Health Promotion Program - a Shift in Resource Utilization Towards Primary Care.
Psykosocial insatser för allvarlig psykisk sjukdom (SMI) kan omfördela vårdkostnader från specialiserad psykiatri mot primärvård — en förändring som kan rationalisera resurserna utan att öka totalkostnaden. En svensk studie från Lund University och Sahlgrenska följde 77 patienter under och efter ett sex månader långt interventionsprogram (MINT). Forskarna mätte direkta kostnader för sjukvård, socialtjänst och rättsvård med RUMI-instrumentet. Resultatet visar att kostnaderna för fysisk och psykiatrisk vård minskade både under och efter interventionen, medan primärvårdsbesöken förändrades differentierat — läkarbesök minskade men sjuksköterskebesök ökade. Socialtjänstens kostnader förblev oförändrade. För regionala inköpschefer och chefsläkare innebär detta underlag för att omstrukturera vårdkedjan: MINT-liknande program kan flytta upp vården utan att belasta totalkostnaden permanent, givet rätt bemanning i primärvården.
Severe mental illness (SMI), such as schizophrenia, is associated with high physical health morbidity, extensive healthcare utilization, and substantial economic costs. This naturalistic study examined changes in resource utilization, measured as direct costs, following a psychosocial health promotion program (MINT) across social services and physical and psychiatric healthcare. Resource utilization patterns for 77 participants were assessed using the Resource Utilization of Mental Illness (RUMI) instrument during the 6-month intervention and a 6-month follow-up. Data were collected on physical and psychiatric care, social services, and contacts with the justice system. We observed significant changes in both costs and patterns of resource utilization. As anticipated, costs related to social services were unchanged. Total costs increased during the intervention period and decreased at follow-up. Costs associated with physical and psychiatric healthcare decreased during the intervention and continued to decrease during follow-up. At a profession-specific level, significant differences were observed in primary care visits: costs associated with physician visits decreased during the intervention and increased at follow-up, whereas costs related to nurse visits increased during both the intervention and follow-up. Overall, these findings suggest that the MINT intervention may modify patients' patterns of resource utilization across services in ways that better align with patients' needs.