Veterans' service utilization and associated costs following participation in dialectical behavior therapy: a preliminary investigation.
BACKGROUND
Dialectical Behavior Therapy (DBT) is an evidence-based therapy developed for the treatment of suicidal behaviors and disorders characterized by emotional and behavioral dyscontrol that is effective in veteran populations. The impact of DBT on veterans' Veterans Affairs (VA) service utilization and cost is unknown.


METHODS
This study evaluated the impact of DBT in a VA outpatient mental health setting on VA service utilization and cost of services. Veterans treated for symptoms of Borderline Personality Disorder, who had completed at least 6 months of the DBT program were sampled (N = 41). Use of physical and mental health services during the years prior and following DBT was assessed using medical record information.


RESULTS
There was a significant decrease in mental health service utilization. Psychiatric hospitalization dropped in half, and for those with a hospitalization, length of stay decreased significantly. Direct costs associated with all health care were significantly reduced.


CONCLUSIONS
Changes in service utilization resulted in a significant reduction in direct costs of providing care to veterans with symptoms of Borderline Personality Disorder. Additional research is needed to compare the reduction in overall costs to the cost of implementing DBT and to compare these changes to a control group.
Minneapolis VA Health Care System, University of Minnesota Medical School, One Veterans Drive (116A), Minneapolis, MN 55417.
Laura L
LL
Meyers
National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025.
Sara J
SJ
Landes
Minneapolis VA Health Care System, University of Minnesota Medical School, One Veterans Drive (116A), Minneapolis, MN 55417.
Paul
P
Thuras
D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D001521:Behavior Therapy; D001883:Borderline Personality Disorder / Q000191:economics / Q000628:therapy*; D003863:Depression / Q000628:therapy; D004180:Direct Service Costs; D019263:Dysthymic Disorder / Q000628:therapy; D055317:Evidence-Based Practice; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006778:Hospitals, Psychiatric / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy; D019966:Substance-Related Disorders / Q000628:therapy; D013405:Suicide / Q000191:economics / Q000523:psychology; D014481:United States; D014493:United States Department of Veterans Affairs / Q000191:economics / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology; D000092864:Suicide Prevention