Cost-Benefit Analysis of Preventive SPA Therapy Programs Versus Reactive Mental Health Services
DOI:
https://doi.org/10.57125/FS.2024.09.20.11Keywords:
Cost-Effectiveness, Mental Health, Post-Conflict, Prevention, Return on Investment, Societal Perspective.Abstract
Russia’s full-scale invasion of Ukraine has precipitated an unprecedented mental health crisis among millions of internally displaced people. However, no study has directly compared the cost-effectiveness of preventive wellness programmes with reactive mental health services in an active, post-conflict setting. We used propensity score matching to compare a Stress Prevention and Alleviation (SPA) programme (n=50) with reactive care (n=50) among internally displaced persons in Kyiv and Lviv. Outcomes were assessed at baseline, 8-week follow-up, and 6-month follow-up, and the 6-month clinical outcomes were used to undertake a 12-month societal cost–benefit analysis. Return on investment (ROI), social return on investment (SROI), and net monetary benefit were estimated using bootstrap resampling. Compared with reactive care, the SPA programme produced significantly greater improvements in depression (between-group difference -2.7, d=0.72), anxiety (-2.6, d=0.68), and work productivity (-13.1%, d=0.61). The economic evaluation indicated an ROI of 229%, an SROI of 3.8:1, and net societal savings of 510 dollars per participant, with a probability of cost-effectiveness exceeding 95% at a willingness-to-pay threshold of 2,000. These findings provide early empirical evidence from an active conflict context that preventive SPA care is not only clinically superior to reactive services but also economically advantageous, supporting an economic rationale for scaling preventive provision in Ukraine.
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