Category: Health Care System / Public Policy

PS5- #B59 - Cost Analysis of an Intensive Outpatient Program for Youth

Friday, Nov 17
1:30 PM – 2:30 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Behavioral Economics | Adolescents | Treatment-Other

The Affordable Care Act mandates that healthcare providers deliver effective and financially responsible services. Understanding the relationship between intensive outpatient program (IOP) costs and symptom improvement is essential in determining utility for patients because of the various indirect and direct costs associated with the service. Consequently, this study examines the costs associated with the IOP for distressed youth. Archival data obtained from an urban IOP between 2013-2016 was analyzed. More specifically, length of stay (LOS), Global Assessment of Functioning (GAF) scores, and service charges were evaluated. Participants included 45 ethnically diverse youth ages 12 to 17 years who were treated in an IOP. It was hypothesized that patients’ GAF scores would improve over the course of treatment and that this increase in rated functioning would be realized in a cost-effective and time-efficient manner.  Descriptive data revealed that LOS ranged from 3 to 227 days (M = 37.42). Participants showed improvement in GAF scores during the program (M = 5.09). A two-way repeated-measures analysis of variance (ANOVA) was used to test the hypothesis. The ANOVA investigated whether improvements in GAF scores were cost-effective. Additionally, wave analyses, which are applied to change scores and focus on identifying small numbers of sinusoidal functions, showed that for every additional $1,000 charge or 1.4 days of treatment after 37 days in the IOP, GAF scores decreased non-significantly by .02 points (F (1, 42.8) = 1.92, p =.66). This finding signals that LOS greater than 37 days were neither clinically effective nor cost-beneficial.  Additionally, supplementary analyses indicated a medium-sized statistically significant correlation between first and last GAF score, which suggests that changes observed were due to a treatment effect (r= .43, df= 44, p < .01). Although patients’ functioning improved over the course of treatment, the results indicated that for every 1.4 days or approximately $1,000 spent, there was a minimal change in GAF scores.  A dose of 37 days appeared clinically effective and cost-beneficial to most patients and extending the LOS beyond 37 days did not seem to result in efficient care. Thus, there was a dose-effect.  While the study is limited by a small sample size and single setting, it does emphasize the importance of determining the optimal LOS and cost consciousness in behavioral healthcare.

Cameron E. Mosley

Doctoral Student
Palo Alto University
Cupertino, California

Robert Wickham

Palo Alto University

Julia Langer

Bay Area Children's Association

Anaid A. Atasuntseva

Student
Palo Alto University, Pacific Graduate School of Psychology

Nicole D. Wilberding

Ph.D. Student
Center for the Study and Treatment of Anxious Youth at Palo Alto University
Belmont, California

Rebecca N. La Prade

Ph.D. Student
Center for the Study and Treatment of Anxious Youth at Palo Alto University
San Francisco, California

Andrea S. Wister

Ph.D. Student
Center for the Study and Treatment of Anxious Youth at Palo Alto University
Sunnyvale, California

Erica V. Rozbruch

Clinical Psychology Ph.D. Student
Palo Alto University
Mountain View, California

Judy Feezer

Ph.D Student
Center for the Study and Treatment of Anxious Youth at Palo Alto University
Redwood City, California

Thomas Tarshis

Bay Area Children's Association

Robert D. Friedberg

Professor
CSTAY at Palo Alto University
Palo Alto University, California