Shock Therapy Cuts Hospital Costs
NEW YORK (Reuters) -- It may conjure up frightful memories of
scenes in "One Flew Over the Cuckoo's Nest," but
electroconvulsive therapy is actually a safe and cost-effective
treatment for recurrent episodes of major depression, according to
a new study.
During electroconvulsive therapy, or ECT, physicians pass
electric currents into the brains of patients with severe
psychiatric disorders such as major depression, causing the
well-known side effect of convulsions. A researcher at the New York
State Psychiatric Institute, Dr. Mark Olfson, and a team of
colleagues from several institutions used data collected in the 1993
Healthcare Cost and Utilization Project to determine how often ECT
is used, and if its benefits are worth its high financial costs.
They estimated that about 9.4% of the adult inpatients enrolled
in the study who had been diagnosed with recurrent major depression
had received ECT at some point. More than half of these patients
received the shock therapy within 5 days of being hospitalized for a
depressive episode.
In general, patients treated by ECT tended to have more costly
hospital bills. But when the investigators compared the costs of
caring for these patients with the medical costs for patients with
similar clinical characteristics but who did not receive ECT, those
who received ECT actually had shorter, less costly hospital stays.
This "...suggests that hospital costs would have been higher if
ECT were not available for the patients who received it," the
researchers explain in the January issue of the American Journal of
Psychiatry. Yet economically disadvantaged patients were less likely
than privately insured individuals and patients from affluent
neighborhoods to receive shock therapy.
Older adults were more likely to receive ECT, perhaps because
they are more sensitive "...to the side effects of tricyclic
antidepressants," Olfson and colleagues propose. Alternatively,
some data suggest that "...older depressed adults may
preferentially respond to ECT."
The new findings indicate that ECT tends to be used "...in a
highly selective manner..." in the treatment of patients with
recurrent major depression. In light of this study, the authors
suggest that the benefits of shock therapy be revisited.
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