title: Service utilization and expenditures for the treatment of panic disorder.
abstract: The outpatient service utilization and estimated expenditures for the treatment of panic disorder for patients prior to their enrollment in a large clinical trial were examined. Data were drawn from the Cross-National Collaborative Panic Study. The sample consists of 391 patients who met DSM-III criteria for panic disorder and were enrolled at one of the US sites of the trial. The rate and frequency of outpatient mental health visits to primary care and specially mental health providers for the current episode of panic disorder are examined. Estimates of direct expenditures for these services are presented (in 1993 US dollars). Over 70% of the patients used primary care for mental health services whereas about 47% of the patients used specialty mental health services. Nearly half of the patients (46.8%) saw a nonpsychiatrist medical specialist, most often a cardiologist (20.6%). Among all patients, those with more frequent panic attacks were more likely to use some form of outpatient mental health services for panic disorder. Among users of any services, those with more severe impairment were more likely to use specialized mental health services. The mean estimated expenditure for the panic episode was $3339, about half of which was accounted for by specialty mental health expenditures. Among users, the median estimated expenditures was $518 for primary care physicians and $2122 for specialty mental health services. In conclusion, the service utilization in this sample of patients with panic disorder is highly varied. Both the primary care and specialty mental health sectors play prominent roles in the community treatment of panic disorder.
authors.affiliation: Cornell University Medical College, Department of Psychiatry, New York, NY 10021, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Leon
authors.forename: M
authors.initials: M
authors.lastname: Olfson
authors.forename: L
authors.initials: L
authors.lastname: Portera
mesh_terms: D000328:Adult; D000525:Alprazolam / Q000627:therapeutic use; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D003156:Community Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D003431:Cross-Cultural Comparison; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D010348:Patient Care Team / Q000191:economics / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data
chemical_list: D014151:Anti-Anxiety Agents; D000929:Antidepressive Agents, Tricyclic; D007099:Imipramine; D000525:Alprazolam