About 400,000 coronary artery bypass graft surgeries are performed in the U.S. each year, and roughly one in five patients goes on to experience clinical depression. But all that could change because of a telephone.
According to University of Pittsburgh researchers, monitoring patient depression and administering a nurse-led intervention via a phone call bi-weekly not only improves quality of life and mood, but it’s also cost-effective and cost-saving.
Dr. Bruce Rollman, a professor of medicine, psychiatry and clinical and translational science at the University of Pittsburgh School Of Medicine was the lead researcher on the study, “Bypassing the Blues.” He said this type of care has the potential to save more than $165 million in claims in its first year.
“When we applied our treatment model to a group of patients who generate high medical costs, treating depression in this patient population actually reduced cost, or bent the cost curve,” he said.
Previous research has shown this method to be effective, but Rollman said his is the first study that proves just how cost-effective this treatment is, the average cost being about $460. That includes nurse and physician compensation.
Researchers analyzed Medicare and private insurance claims for nearly 200 participants, finding those assigned to the telephone intervention had median claims $2,068 lower than typical in-person physician care one year after bypass surgery ($16,126 vs. $18,194).
Rollman said this type of treatment is so cost-effective because it helps prevent the need for additional tests and therapies.
“Their mood symptoms then become things like chest pain, belly pain, insomnia and so on and these patients are more likely to go see their doctor,” he said. “And if they see their doctor, they’re more likely to get extra tests and even be readmitted.”
The intervention also improved patient’s quality adjusted life years (QALY), a measurement used to determine the value of medical treatments, and lowered claims costs by nearly $10,000 per additional QALY generated.
Rollman said the treatment produced more QALY, while retaining its low cost.
“We were actually negative,” he said, “and probably the only other major things in healthcare that are negative on the quality of life scale are prenatal care and a few vaccines. That’s about it.”
Rollman believes this type of treatment will gain more popularity in the future as hospitals and healthcare providers look to cut costs under the Affordable Care Act.
“There’s a lot of concern that we’ll do more, we’ll give people services, but it’s only going to cost more,” he said. “We can’t really keep spending more and more on healthcare.”