|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$563||Benefits minus costs||$823|
|Participants||$159||Benefit to cost ratio||$2.40|
|Others||$581||Chance the program will produce|
|Indirect||$107||benefits greater than the costs||80 %|
|Net program cost||($588)|
|Benefits minus cost||$823|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Health care associated with major depression||$563||$159||$581||$283||$1,587|
|Mortality associated with depression||$0||$0||$0||$118||$118|
|Adjustment for deadweight cost of program||$0||$0||$0||($294)||($294)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$577||2016||Present value of net program costs (in 2017 dollars)||($588)|
|Comparison costs||$0||2016||Cost range (+ or -)||15 %|
|Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
|Major depressive disorder||72||5||1358||-0.379||0.056||73||-0.197||0.069||75||-0.438||0.001|
Blanchard, M.R., Waterreus, A., & Mann, A.H. (1995). The effect of primary care nurse intervention upon older people screened as depressed. International Journal of Geriatric Psychiatry, 10(4), 289-298.
Bruce, M.L., Ten, H.T.R., Reynolds, C.F., Katz, I.I., Schulberg, H.C., Mulsant, B.H., . . . Alexopoulos, G.S. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized controlled trial. Jama, 291(9), 1081-1091.
Chew-Graham, C.A., Lovell, K., Roberts, C., Baldwin, R., Morley, M., Burns, A., . . . Burroughs, H. (2007). A randomized controlled trial to test the feasibility of a collaborative care model for the management of depression in older people. The British Journal of General Practice, 57(538), 364-370.
Gallo, J.J., Bogner, H.R., Morales, K.H., Post, E.P., Lin, J.Y., & Bruce, M.L. (2007). The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial. Annals of Internal Medicine, 146(10), 689-98.
McCusker, J., Sewitch, M., Cole, M., Yaffe, M., Cappeliez, P., Dawes, M., . . . Latimer, E. (2008). Project Direct: pilot study of a collaborative intervention for depressed seniors. Canadian Journal of Community Mental Health, 27(2), 201-218.
Unützer, J., Katon, W., Callahan, C.M., Williams, J.W., Hunkeler, E., Harpole, L., . . . Lin, E.H.B. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. Journal- American Medical Association, 288, 2836-2845.
Unützer, J., Tang, L., Oishi, S., Katon, W., Williams, J. W., Hunkeler, E., . . . Langston, C. (2006). Reducing suicidal ideation in depressed older primary care patients. Journal of the American Geriatrics Society, 54(10), 1550-1556.