Team Depression Treatment Cuts Total Senior Medical Costs

A team approach to depression treatment, already shown to improve health, can also cut total health-care costs, according to a study co-authored by Kaiser Permanente and published in the February issue of the American Journal of Managed Care.

The results examine the effects of the multi-center IMPACT (Improving Mood -- Promoting Access to Collaborative Treatment for late life depression) care model on the long-term healthcare costs of 551 study participants from Kaiser Permanente of Southern California and Group Health Cooperative of Puget Sound, enrolled in collaboration with the University of Washington. Jurgen Unutzer, MD, of the University of Washington and his fellow researchers found that adults over age 60 who received a year of team care for depression had lower average costs for all of their health care over a four-year period -- about $3,300 less than patients receiving traditional depression care, even when the cost of the team care treatment is included.

Clinical depression affects about 3 million older adults in the United States and is associated with 50 to 70 percent higher health-care expenses, mostly due to an increased use of medical, not mental health, services.

Based on its high effectiveness and cost-effectiveness, Kaiser Permanente of Southern California and Northern California, and several other major health organizations, already have implemented the IMPACT model and IMPACT-type models for depression care.

"Evidence-based models such as IMPACT provide an effective way to identify and treat people with depression, which is a terribly disabling condition," said study co-author Richard D. Della Penna, M.D., medical director of the Kaiser Permanente Aging Network and clinical lead of National Elder Care at the Kaiser Permanente Care Management Institute. "Kaiser Permanente's integrated care delivery system is an ideal fit for the IMPACT model. In Southern California alone, we have reached 6,000 patients with the IMPACT approach and have seen an 80 percent improvement rate in these patients."

The IMPACT treatment model features a depression-care manager (a nurse, social worker or psychologist) who works with the primary care physician and a consulting psychiatrist to care for depressed patients in their primary care clinic.(site study). An earlier study, published in the Dec. 11, 2002, Journal of the American Medical Association, shows that the IMPACT program provides powerful health benefits, including significantly decreased depression and chronic physical pain, improved physical functioning and better overall quality of life.

The cost of using the IMPACT model of depression care treatment is only about $500 per year for each patient -- a modest investment compared to the total medical costs of about $8,000 per year for an older adult with depression. When spread out over an entire population of older adults, the cost of offering IMPACT as a health care benefit amounts to about $1 per person per month.

About Kaiser Permanente

Kaiser Permanente is America's leading integrated health plan. Founded in 1945, it is a not-for-profit; group practice program headquartered in Oakland, Calif. Kaiser Permanente serves 8.7 million members in nine states and the District of Columbia. Today it encompasses the not-for-profit Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the for-profit Permanente Medical Groups. Nationwide, Kaiser Permanente includes approximately 156,000 technical, administrative and clerical employees and caregivers, and 13,000 physicians representing all specialties. For more information about Kaiser Permanente, visit the Kaiser Permanente News Center at: http://xnet.kp.org/newscenter .
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