Assessing the impact of psychoanalyses and long-term psychoanalytic therapies on health care utilization and costs

Studies on the long-term cost-effectiveness of psychotherapies are still rare. In the context of a retrospective long-term follow-up study, the authors assessed work loss and hospitalization days before, during, and after psychoanalytic treatments based on patients' self-reports and health insurance records. They also determined the correlation between patients' ratings and health insurance data. Health insurance records showed evidence of a lasting and remarkably stable reduction in work absenteeism and a low level of inpatient treatments. These trends contrasted favorably with the age-related increase in sick leave among the general population. Patients' self-reports reflected the general trend of the health insurance data but were not accurate enough to estimate costs and savings. Even disregarding other illness-related costs, based on health insurance records, considerable savings accrued over the 7-year follow-up period in terms of reduced absenteeism from work. Advantages (e.g., long follow-up periods) and limitations (e.g., selection) of collecting health insurance data are discussed.