Bypassing the Blues, a University of Pittsburgh trial program, found up to half of CABG patients report higher levels of depression after their surgery. Consequently, those patients are more likely to suffer from adverse outcomes, including higher rates of readmission and death, as well as increased long-term health costs.
The study, published in General Hospital Psychiatry and part of Bypassing the Blues, combed through Medicare and private health insurance claims of 189 people who underwent CABG surgery. Some patients went through a special intervention—they were screened for depression, and a nurse-led “collaborative care” team then followed up with patients via telephone to monitor their moods. This added about $460 on average in initial costs, but patients who went through the depression intervention had lower medical claims costs in the long run. CABG patients with the intervention had $16,126 in average claims costs within a year of surgery, compared with $18,194 for patients who received routine care without depression monitoring during the same time span.
The intervention also gave CABG patients more quality-adjusted life years, a measure used to put a value on a health outcome.
Justifying the expenses of mental health services is generally a tough sell, especially in a day and age when states are not shy about cutting funds for those services. But researchers are optimistic that at least for CABG patients, a team-based model that incorporates treatment for depression could become part of a new routine.
“One of the holy grails in mental health services research is to demonstrate that treating a common mental health condition such as depression is not only effective and cost-effective, but is also cost-saving,” Dr. Bruce Rollman, a professor of medicine and psychiatry at the University of Pittsburgh School of Medicine and author of the study, said in a news release. “This is the first trial to demonstrate all three outcomes. We now know that screening for and then providing effective depression treatment to medically complex patients with cardiovascular disease is very likely to pay for itself.”
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