title: Impact of mindfulness-based cognitive therapy on health care utilization: a population-based controlled comparison.
abstract: OBJECTIVE
  Elevated rates of mood and anxiety disorders among high utilizers of health care have been suggested as one driver of increased service use. We compared the impact of Mindfulness Based Cognitive Therapy (MBCT), a structured group treatment, on the rates of health care utilization with matched control participants receiving non-MBCT group therapy.
  
  
  METHODS
  Using Ontario health administrative data, we created a retrospective cohort of population-based patients receiving MBCT and an age- and gender-matched (3:1) cohort of non-MBCT group therapy controls. Subjects were recruited between 2003 and 2010 and stratified according to high/low rates of primary care utilization, with the high utilization cohort being the cohort of interest. The primary outcome was a reduction in an aggregate measure of non-mental health utilization comprising Emergency Department, non-mental health primary care, and non-psychiatrist specialist visits.
  
  
  RESULTS
  There were 10,633 MBCT recipients, 4851 (46%) of whom were high utilizers. The proportion of high utilizers was 13,274 (45%, N=29,795) for non-MBCT group therapy controls. Among high utilizers, there was a significant reduction in non-mental health utilization among MBCT recipients compared to non-MBCT group therapy recipients (0.55 (0.21-0.89)) suggesting that for every two MBCT patients treated, there is a reduction in 1 non-mental health visit.
  
  
  CONCLUSIONS
  Among high utilizers of primary care, MBCT reduced non-mental health care utilization 1year post-therapy compared to non-MBCT, group therapy controls. The reductions suggest that MBCT, an established treatment modality for a variety of mental illnesses, has the added benefit of reducing distress-related high health care utilization.
authors: Centre for Addiction and Mental Health, Department of Psychiatry University of Toronto, Canada; Institute for Clinical Evaluative Sciences, Canada. Electronic address: paul.kurdyak@camh.ca.
authors: Paul
authors: P
authors: Kurdyak
authors: Institute for Clinical Evaluative Sciences, Canada.
authors: Alice
authors: A
authors: Newman
authors: Department of Psychology, University of Toronto - Scarborough, Canada.
authors: Zindel
authors: Z
authors: Segal
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D064866:Mindfulness; D019964:Mood Disorders / Q000628:therapy; D009864:Ontario; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Health service utilization; Mindfulness-based cognitive therapy; Primary care