Supportive Text Messaging was Associated with Reduced Health Service Utilization Costs in the 6 Months Following...

Psychiatric hospitalizations are a major driver of mental health-related healthcare costs, with readmission risk and service utilization highest in the months following discharge. Scalable, low-cost post-discharge interventions that reduce inpatient utilization are therefore of high policy relevance.

This secondary exploratory economic study used linked administrative healthcare utilization data to evaluate the economic impact of supportive text messaging, alone and in combination with peer support, following discharge from acute psychiatric care.

This secondary exploratory economic evaluation was conducted alongside a pragmatic stepped-wedge cluster-randomized trial in Alberta, Canada. Adults discharged from acute psychiatric inpatient care received treatment as usual (TAU), supportive text messaging (SMS), or supportive text messaging with or without peer support (SMS with or without PSS). Direct health system costs, including hospital care and physician costs, were assessed using administrative data for 6-monthsand 12-months before and after the index admission. Difference-in-differences analyses were used to estimate cost changes between groups.

At six months post-discharge, the period of greatest new costs, participants receiving SMS experienced a significant reduction in hospital care costs compared with TAU (mean difference-in-differences -$7,147; 95% CI -$12,388 to -$1,906; p = 0.01). Total healthcare costs were also significantly lower in the SMS group at six months (-$8,160) relative to TAU. Sensitivity analyses demonstrated that the direction and statistical significance of the primary findings remained stable across alternative intervention costing assumptions and analytic specifications. No significant cost differences were observed at 12- months. The addition of peer support did not result in incremental cost savings at either time point.

Supportive text messaging was associated with significant reductions in hospital care and total healthcare utilization costs during the 6-month post-discharge period compared with treatment as usual These findings support the integration of cost-effective and scalable digital interventions into routine psychiatric discharge pathways to help improve system efficiency in publicly funded health systems.

ClinicalTrials.gov NCT05133726.