Cost of Implementing an Evidence-Based Intervention to Support Safer Use of Antipsychotics in Youth.
Laura Johnson ChavezJulie E RichardsPaul FishmanKai YeungAnne RenzLeeAnn M QuintanaStefan MassiminoRobert B PenfoldPublished in: Administration and policy in mental health (2023)
To estimate the cost of implementing a clinical program designed to support safer use of antipsychotics in children and adolescents (youth) age 3-17 years at the time of initiating an antipsychotic medication. We calculate the costs of implementing a psychiatric consultation and navigation program for youth prescribed antipsychotic medications across 4 health systems, which included an electronic health record (EHR) decision support tool, consultation with a child and adolescent psychiatrist, and up to 6 months of behavioral health care navigation, as well as telemental health for patients (n = 348). Cost data were collected for both start-up and ongoing intervention phases and are estimated over a 1-year period. Data sources included study records and time-in-motion reports, analyzed from a health system perspective. Costs included both labor and nonlabor costs (2019 US dollars). The average total start-up and ongoing costs per health system were $34,007 and $185,174, respectively. The average total cost per patient was $2,128. The highest average ongoing labor cost components were telemental health ($901 per patient), followed by child and adolescent psychiatrist consultation ($659), and the lowest cost component was primary care/behavioral health provider time to review/respond to the EHR decision support tool and case consultation ($24). For health systems considering programs to promote safer and targeted use of antipsychotics among youth, this study provides estimates of the full start-up and ongoing costs of an EHR decision support tool, psychiatric consultation service, and psychotherapeutic services for patients and families.Trial registration: Clinicaltrials.gov, NCT03448575.
Keyphrases
- mental health
- electronic health record
- healthcare
- primary care
- palliative care
- young adults
- end stage renal disease
- quality improvement
- newly diagnosed
- public health
- prognostic factors
- adverse drug
- ejection fraction
- chronic kidney disease
- randomized controlled trial
- physical activity
- clinical decision support
- patient reported outcomes
- emergency department
- case report
- risk assessment
- machine learning
- health information
- high speed
- deep learning
- phase iii
- health promotion