PMC:5332029 / 34046-36057 JSONTXT

{"project":"2_test","denotations":[{"id":"28249032-1845222-91797307","span":{"begin":421,"end":423},"obj":"1845222"},{"id":"28249032-12369475-91797307","span":{"begin":421,"end":423},"obj":"12369475"},{"id":"28249032-20970117-91797307","span":{"begin":421,"end":423},"obj":"20970117"},{"id":"28249032-22964561-91797308","span":{"begin":427,"end":429},"obj":"22964561"},{"id":"28249032-12505818-91797309","span":{"begin":769,"end":771},"obj":"12505818"},{"id":"28249032-10518167-91797310","span":{"begin":772,"end":774},"obj":"10518167"},{"id":"28249032-20667602-91797311","span":{"begin":781,"end":783},"obj":"20667602"},{"id":"28249032-23637110-91797312","span":{"begin":790,"end":792},"obj":"23637110"},{"id":"28249032-21119151-91797313","span":{"begin":803,"end":805},"obj":"21119151"},{"id":"28249032-17032159-91797314","span":{"begin":817,"end":819},"obj":"17032159"},{"id":"28249032-12946081-91797315","span":{"begin":831,"end":833},"obj":"12946081"}],"text":"Secondary analysis\nWe furthermore were interested in whether there were detectable differences in the cost-benefit of different types of psychological therapy. We were able to find six studies of DBT and seven non-DBT alternative approaches. There are not enough studies to directly compare two alternative approaches to date, we therefore pooled the seven non-DBT studies. DBT was compared to TAU in six evaluations [33,40–43,45]. The (weighted) mean cost-offset derived from the provision of DBT compared to TAU was USD $78.43 [SD = $3,1412.83; SE = $184.01] per patient per year across these studies (total sample size n = 344). Seven non-DBT evaluations focused on the post- healthcare costs related to the provision of other psychological approaches, namely: MBT [25,47]; CI [48]; CP [49]; CBT-PD [51]; CBT-TAU [26] and MACT [50]. Compared to TAU, a (weighted) mean increase in costs of USD -$1,150.03 [SD = $5,482.33; SE = $170.91] per patient per year was demonstrated across the studies (total sample size n = 1029).\nThe weighted mean difference in cost savings vs. TAU derived after the provision of DBT vs. non-DBT studies was: $1,228.43 (SE = $251.13; 95% confidence interval $735.63 to $1,721.30). This resulted in a significant weigthed mean difference (t(953.33.) = 4.892, p = .000). Although the difference per patient is significant, it is important to recognise that treatments themselves begin from different cost bases–and DBT standard includes weekly 2.5 hours of group, one hour of individual and ancillary care and phone coaching–which is generally more intensive that the comparative treatments which are typically up to two hours individual per week. In addition, crisis care, because it diverts from hospitalisation, has a large cost-offset. Although there are many potential interpretations for this significant finding, it could suggest that there is a greater cost-benefit of non-DBT vs DBT approaches compared to TAU. However, caution should be used when interpreting these results."}