Health Care Service Utilization Among People with HIV, Chronic Pain, and Depression: Utilization and Cost Outcomes from the HIV-PASS Study.

Autor: Moitra E; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA. ethan_moitra@brown.edu., Stein MD; Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, USA.; Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA., Busch AM; Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA.; Department of Medicine, University of Minnesota - Twin Cities, Minneapolis, MN, USA., Pinkston MM; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.; Lifespan Physicians Group, Rhode Island Hospital, Providence, RI, USA.; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA., Bray JW; Department of Economics, UNC Greensboro, Greensboro, NC, USA., Abrantes AM; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.; Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, USA., Baker JV; Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA.; Department of Medicine, University of Minnesota - Twin Cities, Minneapolis, MN, USA., Weisberg RB; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.; Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI, USA.; RealizedCare, Elizabethtown, KY, USA., Anderson BJ; Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, USA., Uebelacker LA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.; Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, USA.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2024 Nov 15. Date of Electronic Publication: 2024 Nov 15.
DOI: 10.1007/s10461-024-04554-1
Abstrakt: In the United States (U.S.), 90% of annual health care expenditures are devoted to people with chronic physical and mental health conditions. For people with HIV (PWH), two common, chronic comorbidities are pain and depression. This report assesses the impact of a brief psychotherapy intervention for PWH and comorbid chronic pain and depression on health care service utilization. Data from the HIV Pain and Sadness Study (HIV-PASS) randomized trial were used. Electronic health records were reviewed to tabulate use of the following services: (a) outpatient rehabilitation; (b) outpatient psychiatric; and (c) hospital-based (e.g., emergency department). Estimated average marginal effects were analyzed to determine how many times a participant accessed the service and the charge at each event. The sample consisted of 187 adults recruited from three U.S. sites. Individuals randomized to the three-month, seven session HIV-PASS intervention had average charges for hospital-based services that were significantly less during the post-treatment phase (months 4-12; 95%CI: -$16,612, -$131; p =.046) than those randomized to the comparison condition. On average, comparison condition participants were charged $8,371 more for hospital services in the 8-month period following intervention. No significant differences between treatment conditions were observed in use of outpatient rehabilitation, outpatient psychiatric services, or hospital-based care. Consistent with predictions, lower health care charges among those randomized to the HIV-PASS behavioral intervention were incurred for hospital services, indicating that a brief behavioral intervention could lead to decreased use of more emergent and expensive care services among persons with HIV, depression, and chronic pain.
Competing Interests: Declarations Conflict of Interest Dr. Uebelacker’s spouse is employed by Abbvie Pharmaceuticals. Dr. Weisberg is the Chief Clinical Officer for RealizedCare. RealizedCare makes virtual reality-based behavioral health interventions for common problems including pain and depression. The authors declare no other relevant financial or non-financial interests.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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