title: Impact of deductibles on initiation and continuation of psychotherapy for treatment of depression.
abstract: OBJECTIVE
  To estimate the impact of deductibles on the initiation and continuation of psychotherapy for depression.
  
  
  METHODS
  Data from health care encounters and claims from Group Health Cooperative, a large integrated health care system in Washington State, was merged with information from a centralized behavioral health triage call center to conduct study analyses.
  
  
  METHODS
  A retrospective observational design using a hierarchical logistic regression model was used to estimate initiation and continuation probabilities for use of psychotherapy, adjusting for key sociodemographic/economic factors and prior use of behavioral health services relevant to individual decisions to seek mental health care.
  
  
  METHODS
  Analyses were based on merged datasets on patient enrollment, insurance benefits, use of mental health and general medical services and information collected by a triage specialist at a centralized behavioral health call center.
  
  
  RESULTS
  Among individuals with unmet deductibles between $100 and $500, we found a statistically significant lower likelihood of making an initial visit, but there was no statistically significant effect on making an initial or subsequent visit among individuals that had met their deductible.
  
  
  CONCLUSIONS
  Unmet deductibles appear to influence the likelihood of initiating psychotherapy for treating depression.
authors.affiliation: Group Health Research Institute and University of Washington, Seattle, WA 98101, USA. fishman.p@ghc.org
authors.forename: Paul A
authors.initials: PA
authors.lastname: Fishman
authors.forename: Victoria
authors.initials: V
authors.lastname: Ding
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hubbard
authors.forename: Evette J
authors.initials: EJ
authors.lastname: Ludman
authors.forename: Chester
authors.initials: C
authors.lastname: Pabiniak
authors.forename: Christine
authors.initials: C
authors.lastname: Stewart
authors.forename: Leo
authors.initials: L
authors.lastname: Morales
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Simon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003669:Deductibles and Coinsurance; D003863:Depression / Q000628:therapy*; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000191:economics*; D012189:Retrospective Studies; D014861:Washington