Cost-effectiveness of specialized psychological programs for reducing hospital stays and outpatient visits

Four naturalistic time‐series studies contrasted adult male patients' use of hospital and clinic resources before and after their involvement in psychologist‐directed programs of stress management, pain control, vocational rehabilitation, and coping skill training. Six months after biofeedback training, utilization rates for hospital days and clinic visits dropped 72% and 63%, respectively. One‐year follow‐ups showed that graduates of two vocational rehabilitation programs had reduced hospital days by 81 to 89% and clinic visits by 23 to 41%. After 1 year, graduates of an inpatient chronic pain program reduced former levels of hospital and clinic utilization by 72% and 50%, respectively. Three years later, hospital days of former pain patients remained 47% less than pretreatment, while clinic visits rose to pretreatment levels. Estimated medical cost‐offsets from the four programs exceeded $7 million.