title: Outpatient Psychotherapy Reduces Health-Care Costs: A Study of 22,294 Insurants over 5 Years.
abstract: BACKGROUND
  The project "Quality Assurance in Ambulatory Psychotherapy in Bavaria" (QS-PSY-BAY) focuses on the quality assurance of outpatient psychotherapy (OPT) in Germany in terms of symptom reduction and cost reduction under naturalistic conditions. In this study, we examined the effectiveness of psychotherapy in terms of pre-post cost reduction.
  
  
  METHODS
  The health-care costs of N = 22,294 insurants over a 5-year period were examined in a naturalistic longitudinal design. Six participating health insurance funds provided data on costs related to inpatient treatment, outpatient treatment, drugs, and hospitalization and work disability days.
  
  
  RESULTS
  We found that the average annual total costs for inpatient and outpatient treatments as well as drug costs and work disability days increased from the second to the first year before OPT. Besides a large and significant reduction of work disability days (41.8%), hospitalization days (27.4%), and inpatient costs (21.5%) from the first year before versus the first year following OPT, we found evidence for long-term effects: the number of work disability days in the second year after OPT was lower (23.8%), and drug costs were higher than in the second year before OPT (41.5%).
  
  
  CONCLUSIONS
  We conclude that OPT as a part of the health insurance system is an investment which can pay off in the future especially in terms of lower inpatient costs and work disability.
authors.affiliation: Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena , Jena , Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Altmann
authors.affiliation: Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena , Jena , Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Zimmermann
authors.affiliation: Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena , Jena , Germany.
authors.forename: Helmut A
authors.initials: HA
authors.lastname: Kirchmann
authors.affiliation: Bavarian Association of Statutory Health Insurance Physicians , Munich , Germany.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Kramer
authors.affiliation: Bavarian Association of Statutory Health Insurance Physicians , Munich , Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fembacher
authors.affiliation: Psychotherapist in Private Practice , Feldafing , Germany.
authors.forename: Ellen
authors.initials: E
authors.lastname: Bruckmayer
authors.affiliation: Medical Specialist for Psychosomatic Medicine and Psychotherapy in Private Practice , Munich , Germany.
authors.forename: Irmgard
authors.initials: I
authors.lastname: Pfaffinger
authors.affiliation: Qualitas GmbH , Munich , Germany.
authors.forename: Fritz
authors.initials: F
authors.lastname: von Heymann
authors.affiliation: Medical Specialist for Psychosomatic Medicine and Psychotherapy in Private Practice , Munich , Germany.
authors.forename: Emma
authors.initials: E
authors.lastname: Auch
authors.affiliation: Institute of Psychology, Friedrich-Schiller-University Jena , Jena , Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Steyer
authors.affiliation: Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena , Jena , Germany.
authors.forename: Bernhard M
authors.initials: BM
authors.lastname: Strauss
keywords: cost reduction; economic benefits; health-care utilization; mental disorder; outpatient psychotherapy