The effects of social support and education on health care costs after three years

To determine whether experimentally developed social support, education about appropriate use of the health care system, and their combination are effective in reducing health care costs for people with osteoarthritis at a 3-year followup assessment. Three hundred sixty-three health maintenance organization members with osteoarthritis were randomly assigned to 1 of 3 intervention groups or to a control group. Two hundred fifty-six participants completed the 3-year assessment. Health status and health care use were assessed upon entering the study, and after 1, 2, and 3 years. Health care costs in the combined experimental groups were lower than those in the control group by $1,279/participant/year in year 3. There were no significant changes in health status between participants' entry into the study and the year 3 assessment. The 3 interventions had nearly equal effects on health status and health care costs. Implementation costs were least for the social support intervention, but the group that combined education and social support had less attrition and greater persistence. Interventions that target appropriate use of the health care system can be highly cost-effective without adversely affecting health status.