Multisystemic Treatment of Poorly Controlled Type 1 Diabetes: Effects on Medical Resource Utilization

Objective To determine whether multisystemic therapy (MST), an intensive, home-based psychotherapy, could decrease rates of hospital utilization and related costs of care among adolescents with poorly controlled type diabetes. Methods Thirty-one adolescents were randomly assigned to receive either M...

Full description

Saved in:
Bibliographic Details
Published in:Journal of pediatric psychology 2005-12, Vol.30 (8), p.656-666
Main Authors: Ellis, Deborah A., Naar-King, Sylvie, Frey, Maureen, Templin, Thomas, Rowland, Melisa, Cakan, Nedim
Format: Article
Language:English
Subjects:
Adolescent
Adult
Analysis of Variance
Biological and medical sciences
diabetes
Diabetes Mellitus, Type 1 - economics
Diabetes Mellitus, Type 1 - psychology
Diabetes Mellitus, Type 1 - therapy
Diabetic Ketoacidosis - economics
Diabetic Ketoacidosis - prevention & control
Family psychotherapy. Systemic therapy
Female
Glycated Hemoglobin A - metabolism
Health Care Costs
Health Services - utilization
Humans
ketoacidosis
Male
Medical sciences
multisystemic therapy
Patient Compliance - psychology
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychotherapies. Psychological and clinical counseling
Psychotherapy - methods
Self Care - psychology
Treatments
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To determine whether multisystemic therapy (MST), an intensive, home-based psychotherapy, could decrease rates of hospital utilization and related costs of care among adolescents with poorly controlled type diabetes. Methods Thirty-one adolescents were randomly assigned to receive either MST or standard care. MST lasted approximately 6 months, and all participants were followed for 9 months. Rates of inpatient admissions and emergency room (ER) visits were calculated for a 9-month prestudy period and during the 9 months of study participation. The relationship between changes in inpatient admissions and changes in metabolic control was also investigated. Results Intervention participants had a decreasing number of inpatient admissions from the baseline period to the end of the study, whereas the number of inpatient admissions increased for controls. Use of the emergency room did not differ. Related medical charges and direct care costs were significantly lower for adolescents receiving MST. Correlational analyses conducted with a subset of participants indicated that decreases in inpatient admissions were associated with improved metabolic control for MST but not control participants. Conclusions Findings suggest that MST has the potential to decrease inpatient admissions among adolescents with poorly controlled type 1 diabetes.
ISSN:0146-8693
1465-735X
DOI:10.1093/jpepsy/jsi052