Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization.
<h4>Background</h4>Poor psychological and physical resilience in response to stress drives a great deal of health care utilization. Mind-body interventions can reduce stress and build resiliency. The rationale for this study is therefore to estimate the effect of mind-body interventions...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0140212&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849723453869916160 |
|---|---|
| author | James E Stahl Michelle L Dossett A Scott LaJoie John W Denninger Darshan H Mehta Roberta Goldman Gregory L Fricchione Herbert Benson |
| author_facet | James E Stahl Michelle L Dossett A Scott LaJoie John W Denninger Darshan H Mehta Roberta Goldman Gregory L Fricchione Herbert Benson |
| author_sort | James E Stahl |
| collection | DOAJ |
| description | <h4>Background</h4>Poor psychological and physical resilience in response to stress drives a great deal of health care utilization. Mind-body interventions can reduce stress and build resiliency. The rationale for this study is therefore to estimate the effect of mind-body interventions on healthcare utilization.<h4>Objective</h4>Estimate the effect of mind body training, specifically, the Relaxation Response Resiliency Program (3RP) on healthcare utilization.<h4>Design</h4>Retrospective controlled cohort observational study.<h4>Setting</h4>Major US Academic Health Network.<h4>Sample</h4>All patients receiving 3RP at the MGH Benson-Henry Institute from 1/12/2006 to 7/1/2014 (n = 4452), controls (n = 13149) followed for a median of 4.2 years (.85-8.4 yrs).<h4>Measurements</h4>Utilization as measured by billable encounters/year (be/yr) stratified by encounter type: clinical, imaging, laboratory and procedural, by class of chief complaint: e.g., Cardiovascular, and by site of care delivery, e.g., Emergency Department. Subgroup analysis by propensity score matched pre-intervention utilization rate.<h4>Results</h4>At one year, total utilization for the intervention group decreased by 43% [53.5 to 30.5 be/yr] (p <0.0001). Clinical encounters decreased by 41.9% [40 to 23.2 be/yr], imaging by 50.3% [11.5 to 5.7 be/yr], lab encounters by 43.5% [9.8 to 5.6], and procedures by 21.4% [2.2 to 1.7 be/yr], all p < 0.01. The intervention group's Emergency department (ED) visits decreased from 3.6 to 1.7/year (p<0.0001) and Hospital and Urgent care visits converged with the controls. Subgroup analysis (identically matched initial utilization rates-Intervention group: high utilizing controls) showed the intervention group significantly reduced utilization relative to the control group by: 18.3% across all functional categories, 24.7% across all site categories and 25.3% across all clinical categories.<h4>Conclusion</h4>Mind body interventions such as 3RP have the potential to substantially reduce healthcare utilization at relatively low cost and thus can serve as key components in any population health and health care delivery system. |
| format | Article |
| id | doaj-art-265d3dff4b3f45eba16b0e4b05badde0 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-265d3dff4b3f45eba16b0e4b05badde02025-08-20T03:11:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-011010e014021210.1371/journal.pone.0140212Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization.James E StahlMichelle L DossettA Scott LaJoieJohn W DenningerDarshan H MehtaRoberta GoldmanGregory L FricchioneHerbert Benson<h4>Background</h4>Poor psychological and physical resilience in response to stress drives a great deal of health care utilization. Mind-body interventions can reduce stress and build resiliency. The rationale for this study is therefore to estimate the effect of mind-body interventions on healthcare utilization.<h4>Objective</h4>Estimate the effect of mind body training, specifically, the Relaxation Response Resiliency Program (3RP) on healthcare utilization.<h4>Design</h4>Retrospective controlled cohort observational study.<h4>Setting</h4>Major US Academic Health Network.<h4>Sample</h4>All patients receiving 3RP at the MGH Benson-Henry Institute from 1/12/2006 to 7/1/2014 (n = 4452), controls (n = 13149) followed for a median of 4.2 years (.85-8.4 yrs).<h4>Measurements</h4>Utilization as measured by billable encounters/year (be/yr) stratified by encounter type: clinical, imaging, laboratory and procedural, by class of chief complaint: e.g., Cardiovascular, and by site of care delivery, e.g., Emergency Department. Subgroup analysis by propensity score matched pre-intervention utilization rate.<h4>Results</h4>At one year, total utilization for the intervention group decreased by 43% [53.5 to 30.5 be/yr] (p <0.0001). Clinical encounters decreased by 41.9% [40 to 23.2 be/yr], imaging by 50.3% [11.5 to 5.7 be/yr], lab encounters by 43.5% [9.8 to 5.6], and procedures by 21.4% [2.2 to 1.7 be/yr], all p < 0.01. The intervention group's Emergency department (ED) visits decreased from 3.6 to 1.7/year (p<0.0001) and Hospital and Urgent care visits converged with the controls. Subgroup analysis (identically matched initial utilization rates-Intervention group: high utilizing controls) showed the intervention group significantly reduced utilization relative to the control group by: 18.3% across all functional categories, 24.7% across all site categories and 25.3% across all clinical categories.<h4>Conclusion</h4>Mind body interventions such as 3RP have the potential to substantially reduce healthcare utilization at relatively low cost and thus can serve as key components in any population health and health care delivery system.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0140212&type=printable |
| spellingShingle | James E Stahl Michelle L Dossett A Scott LaJoie John W Denninger Darshan H Mehta Roberta Goldman Gregory L Fricchione Herbert Benson Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. PLoS ONE |
| title | Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. |
| title_full | Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. |
| title_fullStr | Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. |
| title_full_unstemmed | Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. |
| title_short | Relaxation Response and Resiliency Training and Its Effect on Healthcare Resource Utilization. |
| title_sort | relaxation response and resiliency training and its effect on healthcare resource utilization |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0140212&type=printable |
| work_keys_str_mv | AT jamesestahl relaxationresponseandresiliencytraininganditseffectonhealthcareresourceutilization AT michelleldossett relaxationresponseandresiliencytraininganditseffectonhealthcareresourceutilization AT ascottlajoie relaxationresponseandresiliencytraininganditseffectonhealthcareresourceutilization AT johnwdenninger relaxationresponseandresiliencytraininganditseffectonhealthcareresourceutilization AT darshanhmehta relaxationresponseandresiliencytraininganditseffectonhealthcareresourceutilization AT robertagoldman relaxationresponseandresiliencytraininganditseffectonhealthcareresourceutilization AT gregorylfricchione relaxationresponseandresiliencytraininganditseffectonhealthcareresourceutilization AT herbertbenson relaxationresponseandresiliencytraininganditseffectonhealthcareresourceutilization |