Evaluating the Cost Effectiveness of ISTDP: A Quasi Experimental Study

Study Overview
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Brief Summary
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Objective: To evaluate whether or not cases treated with Intensive Short-term Dynamic Psychotherapy (ISTDP) facilitate healthcare cost reduction, whether any observed reduction is greater than that of a control group and whether any such gains would be maintained in follow up. Design: A quasi-experimental design was employed in which pre and post healthcare cost and usage data were extracted for all ISTDP treated cases from 1999 to 2008 and compared to parallel measures of a control group of cases referred but never treated.

Detailed Description
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Importance: Psychiatric and psychological disorders result in excess health care service use and costs. Brief psychotherapy methods may be effective across a broad range of mental disorders and could therefore result in healthcare cost reduction. Objective: To evaluate whether or not cases treated with Intensive Short-term Dynamic Psychotherapy (ISTDP) facilitate healthcare cost reduction, whether any observed reduction is greater than that of a control group and whether any such gains would be maintained in follow up. Design: A quasi-experimental design was employed in which pre and post healthcare cost and usage data were extracted for all ISTDP treated cases from 1999 to 2008 and compared to parallel measures of a control group of cases referred but never treated. Setting: Treatments were provided at an urban University based psychotherapy service. Participants: All cases from the province of Nova Scotia treated within the research time frame were included. 890 patients were included with a very broad range of psychiatric disorders including anxiety, mood, somatoform, personality and psychotic disorders. 192 referred but never see cases served as non randomized controls. Intervention(s): ISTDP is an emotionally focused form of brief psychotherapy which has supportive, cognitive, experiential and primarily psychodynamic elements. In this setting the average length of treatment was 7.3 sessions and cost an estimated $500 dollars per treatment course.

Official Title
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Evaluating the Cost Effectiveness of ISTDP: A Quasi Experimental Study

Conditions
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Anxiety, Somatoform Disorders, Personality Disorders, Depression, Psychotic Disorders

Intervention / Treatment
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* Behavioral: ISTDP


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients referred for ISTDP treatment Exclusion Criteria: Patients not referred for ISTDP treatment

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ISTDP<br>Patients provided Intensive Short term Dynamic Psychotherapy | Behavioral: ISTDP<br>* An emotion focused brief psychotherapy format.<br>* Other names: Intensive Short-term Dynamic Psychotherapy;|
| Control Group<br>Patients referred for ISTDP but never seen for any reason | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total Doctor and Hospital Costs | Total Physician and Hospital billings per patient | 1 year pre versus 3 years post | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital costs | Total Hospital costs per patient | 1 year pre versus 3 years post | 
| Hospital Days | Hospital days per patient | 1 year per versus 3 years post | 
| Doctor Visits | Doctor Costs per patient | 1 year pre versus 3 years post | 
| Doctor Costs | Doctor costs per patient | 1 year pre versus 3 years post | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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somatoform disorder, psychotherapy, depression, anxiety, personality disorder