![ORCID Icon]({"type":"image","src":"/templates/jsp/_style2/_tandf/images/orcid.svg"} "ORCID Icon"){kind=small}
https://orcid.org/0000-0001-8757-6587
![Sample our Bioscience journals, sign in here to start your access, Latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5925/TOC-Subject-Sample-2021-Bioscience.jpg"})
![Publish Open Access Finland]({"type":"image" , "src" : "/sda/110396/JournalAd-OA-Agreements.gif"})
![Electronic Banner Advert for Current Medical Research and Opinion]({"type":"image" , "src" : "/sda/111144/JournalAd-Announce-ICMO-LM.jpg"})
Abstract
Objective
To determine the impact of telemental health (TMH) use on total healthcare costs and mental health (MH)-related costs paid by a third party among adults with mental health conditions (MHC).
Method
This study employed a pre-post design with a non-equivalent control group. The cohort comprised adults with MHCs identified using diagnosis codes from de-identified claims data of the Optum Clinformatics DataMart (2010 January 01 to 2017 June 30). We identified mental health (MH) service users and TMH users (N = 348) based on procedure codes. Non-users (N = 238,595) were defined as those who only used in-person MH services. A Difference-in-Differences (DID) analysis was performed within a multivariable two-part model (TPM) framework to examine the impact of TMH use on adjusted standardized costs (2018 US $) of all healthcare services and MH services. Patient-level and state-level factors were adjusted in TPM.
Results
TMH use was associated with significantly higher MH-related costs [Marginal effect = $461.3, 95% confidence interval: $142.4–$780.2] and an excess of $370 increase in MH-related costs at follow-up as compared to baseline. However, TMH use was not associated with an increase in total third-party healthcare costs nor with changes in total costs from baseline to follow-up.
Conclusions
Despite having a higher likelihood of MH services use and MH-related costs, TMH users did not have higher total costs as compared to adults using only in-person MH services. Our findings suggest that TMH can increase access to MH care without increasing total healthcare costs among adults with MHC. Future studies exploring whether TMH use can lead to cost-savings over a longer period are warranted.
Acknowledgements
No assistance in the preparation of this article is to be declared.
Transparency
Declaration of funding
Research reported in this manuscript was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number U54GM104942, WVCTSI. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Declaration of financial/other relationships
The authors report no conflicts of interest. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
All authors contributed to the conception, and design of the research. The first author conducted the statistical analyses and wrote the first draft. All authors worked on successive iterations.
Data availability statement
This retrospective database study used commercial claims data from the Optum Clinformatics Data Mart (Eden Prairie, MN, USA) spanning 1 January 2010 to 30 June 2017. The claims data that support the findings of this study are from a proprietary administrative claims database and are not publicly available. However, summary data tables are available from the authors upon reasonable request.