Photo Credit: Vadym Terelyuk
A randomized clinical trial reveals that a mental health intervention, including case management and psychotherapy, significantly reduces emergency room and hospital utilization over a 5-year period, suggesting potential cost savings and emphasizing the importance of integrating mental health measures in trauma center protocols.
The following is a summary of “Emergency Department and Inpatient Utilization Reductions and Cost Savings Associated With Trauma Center Mental Health Intervention, Results From a 5-year Longitudinal Randomized Clinical Trial Analysis” published in the January 2024 issue of Surgery by Prater, et al.
The American College of Surgeons Committee on Trauma now requires trauma centers to have processes in place so that they can find patients who are at high risk for the psychological effects of physical damage and send them to other services. No studies have shown that trauma center mental health measures lead to fewer visits to the hospital and possible cost savings. The study was a randomized clinical trial review that included new follow-up data on emergency department (ED) and hospital health service use from the past 5 years.
Patients were randomly assigned to either a mental health intervention aimed at the psychological effects of traumatic injury (n = 85) or improved normal care control (n = 86). Case management, psychiatric drug advice, and psychotherapy were all parts of the strategy. Case management managed care links between trauma centers and the community. They used mixed model regression to examine how the training and control groups’ use of resources changed over time. There was also a business study.
Patients significantly decreased their use of emergency rooms and hospitals throughout the 5-year intervention compared to control patients [F (19,3210) = 2.23, P = 0.009]. When compared to the control group, intervention use dropped the most between 3 and 6 months (intervention 15.5% vs. control 26.7%, relative risk = 0.58, 95% CI: 0.34 to 1.00) and 12 to 15 months (intervention 16.5% vs. control 30.6%, relative risk = 0.54, 95% CI: 0.32 to 0.91). The economic study showed that there might be cost savings from action. Interventions in mental health are linked to big drops in the number of people who go to the emergency room or stay in the hospital, as well as possible cost savings. These results could be usefully added to future policy talks by the American College of Surgeons Committee on Trauma.
