Posted: 11.21.2014 | by AMRA
Since stress often contributes to medical illness, it is possible that mindfulness-based interventions (MBIs) that contain a stress reduction component might reduce the need for subsequent medical services. Few studies actually measure post-MBI medical utilization however, probably due to the difficulty in gathering data from an often fragmented healthcare delivery system.
Integrated healthcare systems offer better opportunities for such research. At Kaiser Permanente Colorado, McCubbin et al. [The Permanente Journal] studied the impact of Mindfulness Based Stress Reduction (MBSR) on self-reported physical and mental health, work productivity, and objectively measured healthcare utilization using an uncontrolled pre-post design.
The 38 participants were mostly female (79%) and Hispanic (68%) with an average age of 53 years. Participants being treated for chronic pain, chronic illness, or stress-related disorders were referred to the study by their primary care physicians. Participants were evaluated at baseline, on the final day of the 8-week program, and one year following their last class.
Health care utilization by the study participants was assessed using Kaiser Permanente Colorado electronic administrative and claims data for a six-month period prior to starting the program, and for a 6-month period following the 1-year anniversary of completing the program. Participants showed significant reductions from baseline in their self-rated pain, depression, anxiety, and somatization at the end of the 8-week program. All of these improvements were maintained at one-year follow-up, with some symptoms (pain, depression, anxiety) showing continued significant improvement beyond the initial gains.
Compared to the six-month period prior to the program, in the six-month period following the one year anniversary of program completion, participants made significantly fewer primary care visits (1.8 vs. 0.9), specialty care visits (7.8 vs. 4.8), ER visits (0.2 vs. 0.1), and had fewer hospitalizations (0.1 vs. 0.02).
Although the implications of these findings are limited by the small sample size and lack of a control group, this study provides preliminary support for the ability of MBIs to reduce healthcare utilization in an ethnically diverse sample, thereby increasing their potential value to managed care.
McCubbin, T., Dimidjian, S., Kempe, K., Glassey, M. S., Ross, C., & Beck, A. (2014). Mindfulness-Based stress reduction in an integrated care delivery system: One-Year impacts on patient-centered outcomes and health care utilization. The Permanente Journal, 18(4), 4-9.