The 'offset effect' of mental health treatment on ambulatory medical care utilization and charges. Month-by-month and grouped-month analyses of a five-year study

Arch Gen Psychiatry. 1985 Jun;42(6):573-80. doi: 10.1001/archpsyc.1985.01790290055006.


The five-year ambulatory medical care experience of 400 patients with mental disorders was studied to test the "offset" hypothesis that patients receiving timely mental health specialist treatment have lower subsequent utilization of, and charges for, care than patients not receiving such specialist treatment. Specialist treatment was associated with significant offset savings in utilization and charges for the non-psychiatric medical care of treated patients with either severe or less severe mental disorders. However, the visits and charges for such specialist treatment boosted the overall (nonpsychiatric plus mental health specialist) care utilization and charges of the specialist-treated patients above those of patients treated solely by their nonpsychiatric physicians; this overall increase was especially pronounced for patients with severe mental disorders. The findings suggest the need for randomized prospective offset studies comparing utilization, cost, and clinical outcomes.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Ambulatory Care / economics
  • Ambulatory Care / statistics & numerical data*
  • Community Health Services / economics
  • Community Health Services / statistics & numerical data
  • Costs and Cost Analysis
  • Family Practice / economics
  • Family Practice / statistics & numerical data
  • Fees, Medical
  • Health Maintenance Organizations / economics
  • Health Maintenance Organizations / statistics & numerical data
  • Health Policy
  • Health Services Research
  • Humans
  • Longitudinal Studies
  • Maryland
  • Massachusetts
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Mental Health Services / economics
  • Mental Health Services / statistics & numerical data*
  • Outcome and Process Assessment, Health Care