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23-04-2015 | ORIGINAL PAPER

Cost-Effectiveness of the Mindfulness-Based Stress Reduction Methodology

Auteurs: Royce William Knight, Jim Bean, Andrew S. Wilton, Elizabeth Lin

Gepubliceerd in: Mindfulness | Uitgave 6/2015

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Abstract

The conflicting challenges of increased patient demand and decreased health care resources require a partial shift in responsibility from the health care system back to the individual. Our objective was to see if participation in a group program (mindfulness-based stress reduction (MBSR)) that reduces stress and fosters self-care impacted health care utilization. We did a prospective study of 1730 patients participating in an MBSR program comparing their health care utilization for 1- and 2-year pre-/post-periods with three different matched comparison groups. In both pre-intervention periods, cases had higher overall costs, numbers of physician claims, and utilization of lab facilities when compared with all three comparison groups. Participation in an MBSR program resulted in consistent decreases in utilization across all outcome variables at the 1-year pre/post interval. These decreases were significantly different than the patterns shown by the matched comparisons. Assuming 1500 MBSR participants (close to the number in the “closest” match) times an average savings of $250 would result in $375,000 in savings. These differences disappeared at the 2-year pre/ post interval with the exception of laboratory utilization. Our findings suggest that mindfulness training is effective for short-term reductions in health care use among a group of complex and heavy users. Anecdotal reports suggest MBSR participants stop their formal mindfulness practice within months of completing the program. It may well be that continuing the formal practice of mindfulness is a necessary prerequisite for maintaining the reductions in health care utilization.
Literatuur
go back to reference Bootzin, R. R., & Stevens, S. J. (2005). Adolescents, substance abuse, and the treatment of insomnia and daytime sleepiness. Clinical Psychology Review, 25, 629–644.CrossRefPubMed Bootzin, R. R., & Stevens, S. J. (2005). Adolescents, substance abuse, and the treatment of insomnia and daytime sleepiness. Clinical Psychology Review, 25, 629–644.CrossRefPubMed
go back to reference Brown, R. A. (Ed.). (1987). The essential Reinhold Niebuhr: selected essays and addresses. New Haven: Yale University Press. Brown, R. A. (Ed.). (1987). The essential Reinhold Niebuhr: selected essays and addresses. New Haven: Yale University Press.
go back to reference Browne, G. B., Arpin, K., Corey, P., Fitch, M., & Gafni, A. (1990). Individual correlates of health service utilization and the cost of poor adjustment to chronic illness. Medical Care, 28(1), 43–58.CrossRefPubMed Browne, G. B., Arpin, K., Corey, P., Fitch, M., & Gafni, A. (1990). Individual correlates of health service utilization and the cost of poor adjustment to chronic illness. Medical Care, 28(1), 43–58.CrossRefPubMed
go back to reference Canadian Institute for Health Information. (2014). National health expenditure trends, 1975 to 2014. Ottawa: Author. Canadian Institute for Health Information. (2014). National health expenditure trends, 1975 to 2014. Ottawa: Author.
go back to reference Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress of stress and immune parameters in breast and prostate cancer outpatients. Psychosomatic Medicine, 65, 571–581.CrossRefPubMed Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress of stress and immune parameters in breast and prostate cancer outpatients. Psychosomatic Medicine, 65, 571–581.CrossRefPubMed
go back to reference Durlak, J. A. (2009). How to select, calculate, and interpret effect sizes. Journal of Pediatric Psychology, 34(9), 917–928.CrossRefPubMed Durlak, J. A. (2009). How to select, calculate, and interpret effect sizes. Journal of Pediatric Psychology, 34(9), 917–928.CrossRefPubMed
go back to reference Friedman, R., Sobel, D., Myers, P., Caudill, M., & Benson, H. (1995). Behavioral medicine, clinical health psychology, and cost offset. Health Psychology, 14(6), 509–518.CrossRefPubMed Friedman, R., Sobel, D., Myers, P., Caudill, M., & Benson, H. (1995). Behavioral medicine, clinical health psychology, and cost offset. Health Psychology, 14(6), 509–518.CrossRefPubMed
go back to reference Goetzel, R. (2001). The financial impact of health promotion and disease prevention programs—why is it so hard to prove value? American Journal of Health Promotion, 15(5), 277–280.CrossRefPubMed Goetzel, R. (2001). The financial impact of health promotion and disease prevention programs—why is it so hard to prove value? American Journal of Health Promotion, 15(5), 277–280.CrossRefPubMed
go back to reference Gross, C. R., Kreitzer, M. J., Russas, V., Treesak, C., Frazier, P. A., & Hertz, M. I. (2004). Mindfulness meditation to reduce symptoms after organ transplant: a pilot study. Advances in Mind-Body Medicine, 20(2), 20–29.PubMed Gross, C. R., Kreitzer, M. J., Russas, V., Treesak, C., Frazier, P. A., & Hertz, M. I. (2004). Mindfulness meditation to reduce symptoms after organ transplant: a pilot study. Advances in Mind-Body Medicine, 20(2), 20–29.PubMed
go back to reference Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57(1), 35–43.CrossRefPubMed Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57(1), 35–43.CrossRefPubMed
go back to reference Health Canada. (1997). Supporting self-care: the contribution of nurses and physicians, an exploratory study. Ottawa: Minister of Public Works and Government Services Canada. Health Canada. (1997). Supporting self-care: the contribution of nurses and physicians, an exploratory study. Ottawa: Minister of Public Works and Government Services Canada.
go back to reference Hellman, C. J., Budd, M., Borysenko, J., McClelland, D. C., & Benson, H. (1990). A study of the effectiveness of two group behavioral medicine interventions for patients with psychosomatic complaints. Behavioral Medicine, 16, 165–173.CrossRefPubMed Hellman, C. J., Budd, M., Borysenko, J., McClelland, D. C., & Benson, H. (1990). A study of the effectiveness of two group behavioral medicine interventions for patients with psychosomatic complaints. Behavioral Medicine, 16, 165–173.CrossRefPubMed
go back to reference Herron, R. (2011). Changes in physician costs among high-cost transcendental meditation practitioners compared with high-cost non-practitioners over 5 years. American Journal of Health Promotion, 26(1), 56–60. Herron, R. (2011). Changes in physician costs among high-cost transcendental meditation practitioners compared with high-cost non-practitioners over 5 years. American Journal of Health Promotion, 26(1), 56–60.
go back to reference Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based of the practice of mindfulness meditation: theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47.CrossRefPubMed Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based of the practice of mindfulness meditation: theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47.CrossRefPubMed
go back to reference Kabat-Zinn, J. (1987). Six-month hospital visit cost reductions in medical patients following self-regulatory training. Washington, D.C.: Poster presented at Society of Behavioral Medicine. Kabat-Zinn, J. (1987). Six-month hospital visit cost reductions in medical patients following self-regulatory training. Washington, D.C.: Poster presented at Society of Behavioral Medicine.
go back to reference Kabat-Zinn, J. (1990). Full catastrophe living. New York: Delta. Kabat-Zinn, J. (1990). Full catastrophe living. New York: Delta.
go back to reference Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8(2), 163–190.CrossRefPubMed Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8(2), 163–190.CrossRefPubMed
go back to reference Kabat-Zinn, J., Lipworth, L., Burney, R., & Sellers, W. (1986). Four year follow-up of a meditation-based program for the self-regulation of chronic pain: treatment outcomes and compliance. Clinical Journal of Pain, 2, 159–173.CrossRef Kabat-Zinn, J., Lipworth, L., Burney, R., & Sellers, W. (1986). Four year follow-up of a meditation-based program for the self-regulation of chronic pain: treatment outcomes and compliance. Clinical Journal of Pain, 2, 159–173.CrossRef
go back to reference Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. B., Fletcher, K. E., Pbert, L., Lenderking, W. R., & Santorelli, S. F. (1992). Effectiveness of meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychology, 149, 936–943.CrossRef Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. B., Fletcher, K. E., Pbert, L., Lenderking, W. R., & Santorelli, S. F. (1992). Effectiveness of meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychology, 149, 936–943.CrossRef
go back to reference Kaplan, K., Goldenberg, D., & Galvin-Nadeau, M. (1993). The impact of a meditation based stress reduction program in fibromyalgia. General Hospital Psychiatry, 15, 284–289.CrossRefPubMed Kaplan, K., Goldenberg, D., & Galvin-Nadeau, M. (1993). The impact of a meditation based stress reduction program in fibromyalgia. General Hospital Psychiatry, 15, 284–289.CrossRefPubMed
go back to reference Kristeller, J., & Hallett, C. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology, 4(3), 357–363.CrossRefPubMed Kristeller, J., & Hallett, C. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology, 4(3), 357–363.CrossRefPubMed
go back to reference Kurdyak, P., Newman, A., & Segal, Z. (2014). Impact of mindfulness-based cognitive therapy on health care utilization: a population-based controlled comparison. Journal of Psychosomatic Research, 77(2), 85–89.PubMed Kurdyak, P., Newman, A., & Segal, Z. (2014). Impact of mindfulness-based cognitive therapy on health care utilization: a population-based controlled comparison. Journal of Psychosomatic Research, 77(2), 85–89.PubMed
go back to reference Lin, E., Diaz-Granados, N., Stewart, D. E., Rhodes, A. E., Yerritsyan, N., Johns, A., Minh, D.-H., & Bierman, A. S. (2009). Depression. In A. S. Bierman (Ed.), Project for an Ontario women’s health evidence-based report, volume 1. Toronto: St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences. Also available at: http://powerstudy.ca/power-report/volume1/depression/. Lin, E., Diaz-Granados, N., Stewart, D. E., Rhodes, A. E., Yerritsyan, N., Johns, A., Minh, D.-H., & Bierman, A. S. (2009). Depression. In A. S. Bierman (Ed.), Project for an Ontario women’s health evidence-based report, volume 1. Toronto: St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences. Also available at: http://​powerstudy.​ca/​power-report/​volume1/​depression/​.
go back to reference Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31–40.CrossRefPubMed Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31–40.CrossRefPubMed
go back to reference Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192–200.CrossRefPubMed Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192–200.CrossRefPubMed
go back to reference Nakagawa, S., & Cuthill, I. C. (2007). Effect size, confidence interval and statistical significance: a practical guide for biologists. Biological Review, 82, 591–605.CrossRef Nakagawa, S., & Cuthill, I. C. (2007). Effect size, confidence interval and statistical significance: a practical guide for biologists. Biological Review, 82, 591–605.CrossRef
go back to reference Ockene, J. K., Sorensen, G., Kabat-Zinn, J., Ockene, I. S., & Donnelly, G. (1988). Benefits and costs of lifestyle changes to reduce risk of chronic disease. Preventive Medicine, 17, 224–234.CrossRefPubMed Ockene, J. K., Sorensen, G., Kabat-Zinn, J., Ockene, I. S., & Donnelly, G. (1988). Benefits and costs of lifestyle changes to reduce risk of chronic disease. Preventive Medicine, 17, 224–234.CrossRefPubMed
go back to reference Reid, R., MacWilliam, L., Roos, N.P., Bogdanovic, B., & Black, C. (1999). Measuring morbidity in populations: performance of the Johns Hopkins Adjusted Clinical Group (ACG) Case-mix Adjustment System in Manitoba. Report to the Manitoba Centre for Health Policy and Evaluation and the Centre for Health Services and Policy Research, University of British Columbia. Retrieved from http://mchp-appserv.cpe.umanitoba.ca/reference/acg.pdf. Reid, R., MacWilliam, L., Roos, N.P., Bogdanovic, B., & Black, C. (1999). Measuring morbidity in populations: performance of the Johns Hopkins Adjusted Clinical Group (ACG) Case-mix Adjustment System in Manitoba. Report to the Manitoba Centre for Health Policy and Evaluation and the Centre for Health Services and Policy Research, University of British Columbia. Retrieved from http://​mchp-appserv.​cpe.​umanitoba.​ca/​reference/​acg.​pdf.
go back to reference Robinson, F. P., Mathews, H. L., & Witek-Janusek, L. (2003). Psycho-endocrine-immune response to mindfulness-based stress reduction in individuals infected with the human immunodeficiency virus: a quasiexperimental study. Journal of Alternative and Complementary Medicine, 9(5), 683–694.CrossRefPubMed Robinson, F. P., Mathews, H. L., & Witek-Janusek, L. (2003). Psycho-endocrine-immune response to mindfulness-based stress reduction in individuals infected with the human immunodeficiency virus: a quasiexperimental study. Journal of Alternative and Complementary Medicine, 9(5), 683–694.CrossRefPubMed
go back to reference Rosenzweig, S., Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2007). Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: a pilot study. Alternative Therapies in Health and Medicine, 13(5), 36–37.PubMed Rosenzweig, S., Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2007). Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: a pilot study. Alternative Therapies in Health and Medicine, 13(5), 36–37.PubMed
go back to reference Roth, B., & Stanley, T. (2002). Mindfulness-based stress reduction and healthcare utilization in the inner city: preliminary findings. Alternative Therapies in Health and Medicine, 8(1), 60–66.PubMed Roth, B., & Stanley, T. (2002). Mindfulness-based stress reduction and healthcare utilization in the inner city: preliminary findings. Alternative Therapies in Health and Medicine, 8(1), 60–66.PubMed
go back to reference Ruff, K. M., & MacKenzie, E. R. (2009). The role of mindfulness in healthcare reform: a policy paper. Explore, 5(6), 313–323.CrossRef Ruff, K. M., & MacKenzie, E. R. (2009). The role of mindfulness in healthcare reform: a policy paper. Explore, 5(6), 313–323.CrossRef
go back to reference SAS Institute Inc. (2011). Base SAS® 9.3 procedures guide: statistical procedures. Cary: SAS Institute Inc. SAS Institute Inc. (2011). Base SAS® 9.3 procedures guide: statistical procedures. Cary: SAS Institute Inc.
go back to reference Segal, Z., Williams, M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press. Segal, Z., Williams, M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press.
go back to reference Sephton, S. E., Lynch, G., Weissbecker, I., Ho, I., & Salmon, P. (2001). Effects of a meditation program on symptoms of illness and neuroendocrine responses in women with fibromyalgia. [Conference abstract]. Psychosomatic Medicine, 63(1), 91–92.CrossRef Sephton, S. E., Lynch, G., Weissbecker, I., Ho, I., & Salmon, P. (2001). Effects of a meditation program on symptoms of illness and neuroendocrine responses in women with fibromyalgia. [Conference abstract]. Psychosomatic Medicine, 63(1), 91–92.CrossRef
go back to reference Sobel, D. (2000). Mind matters, money matters: the cost-effectiveness of mind/body medicine. Journal of the American Medical Association, 284(13), 1704.CrossRef Sobel, D. (2000). Mind matters, money matters: the cost-effectiveness of mind/body medicine. Journal of the American Medical Association, 284(13), 1704.CrossRef
go back to reference Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized wait-list controlled trial: the effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62, 613–622.CrossRefPubMed Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized wait-list controlled trial: the effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62, 613–622.CrossRefPubMed
go back to reference Tacon, A. M., McComb, J., Caldera, Y., & Randolph, P. (2003). Mindfulness meditation, anxiety reduction, and heart disease: a pilot study. Family and Community Health, 26(1), 25–33.CrossRefPubMed Tacon, A. M., McComb, J., Caldera, Y., & Randolph, P. (2003). Mindfulness meditation, anxiety reduction, and heart disease: a pilot study. Family and Community Health, 26(1), 25–33.CrossRefPubMed
go back to reference Teasdale, J. D., Segal, Z. V., Williams, J. M., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623.CrossRefPubMed Teasdale, J. D., Segal, Z. V., Williams, J. M., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623.CrossRefPubMed
go back to reference Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy, 19(3), 211–228.CrossRef Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy, 19(3), 211–228.CrossRef
Metagegevens
Titel
Cost-Effectiveness of the Mindfulness-Based Stress Reduction Methodology
Auteurs
Royce William Knight
Jim Bean
Andrew S. Wilton
Elizabeth Lin
Publicatiedatum
23-04-2015
Uitgeverij
Springer US
Gepubliceerd in
Mindfulness / Uitgave 6/2015
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI
https://doi.org/10.1007/s12671-015-0408-5

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