TY - JOUR

T1 - Mental health economics

T2 - A prospective study on psychological flourishing and associations with healthcare costs and sickness benefit transfers in Denmark

AU - Santini, Ziggi Ivan

AU - Nielsen, Line

AU - Hinrichsen, Carsten

AU - Nelausen, Malene Kubstrup

AU - Meilstrup, Charlotte

AU - Koyanagi, Ai

AU - McDaid, David

AU - Lyubomirsky, Sonja

AU - VanderWeele, Tyler J.

AU - Koushede, Vibeke

N1 - Funding Information: None declared. This study is a secondary data analysis with no human subject issues. Ethics statement is included in the paper. We do not have permission to share data. Nordea-fonden. No support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work. The manuscript is an honest, accurate, and transparent account of the study being reported. No important aspects of the study have been omitted. Any discrepancies from the study as planned (and, if relevant, registered) have been explained. Publisher Copyright: © 2021

PY - 2021/12

Y1 - 2021/12

N2 - Background: Escalating healthcare expenditures highlight the need to identify modifiable predictors of the use and costs of healthcare and sickness benefit transfers. We conducted a prospective analysis on Danish data to determine the costs associated with flourishing as compared to the below threshold level of flourishing. Methods: We used data from a 2016 Danish survey of 3508 adults, which was linked to Danish register data. Flourishing was assessed with a validated psychological well-being scale. A two-part regression model was used to predict 2017 costs while adjusting for 2016 costs, demographic variables, and health status, including psychiatric morbidity and health behaviours. Costs are expressed in USD PPP. Results: Applying criteria from prior literature, the prevalence of flourishing in Denmark (measured in 2016) was 34.7%. Flourishing was associated with significantly lower healthcare costs ($-687.7, 95% CI = $-1295.0, $-80.4) and sickness benefit transfers ($-297.8, 95% CI = $-551.5, $-44.0) per person in 2017, as compared to the below threshold level of flourishing. Extrapolated to the Danish population (4.1 M people aged 16+ years), flourishing was associated with lower healthcare costs and sickness benefit transfers amounting to $-1.2bn (95% CI = $-2.3 bn, $-149.0 M). Conclusions: Flourishing is associated with considerably lower health-related government expenditure. Substantial reductions could potentially be achieved by increasing the number of people who are flourishing in the population.

AB - Background: Escalating healthcare expenditures highlight the need to identify modifiable predictors of the use and costs of healthcare and sickness benefit transfers. We conducted a prospective analysis on Danish data to determine the costs associated with flourishing as compared to the below threshold level of flourishing. Methods: We used data from a 2016 Danish survey of 3508 adults, which was linked to Danish register data. Flourishing was assessed with a validated psychological well-being scale. A two-part regression model was used to predict 2017 costs while adjusting for 2016 costs, demographic variables, and health status, including psychiatric morbidity and health behaviours. Costs are expressed in USD PPP. Results: Applying criteria from prior literature, the prevalence of flourishing in Denmark (measured in 2016) was 34.7%. Flourishing was associated with significantly lower healthcare costs ($-687.7, 95% CI = $-1295.0, $-80.4) and sickness benefit transfers ($-297.8, 95% CI = $-551.5, $-44.0) per person in 2017, as compared to the below threshold level of flourishing. Extrapolated to the Danish population (4.1 M people aged 16+ years), flourishing was associated with lower healthcare costs and sickness benefit transfers amounting to $-1.2bn (95% CI = $-2.3 bn, $-149.0 M). Conclusions: Flourishing is associated with considerably lower health-related government expenditure. Substantial reductions could potentially be achieved by increasing the number of people who are flourishing in the population.

KW - Flourishing

KW - Health economics

KW - Healthcare utilization

KW - Mental health

KW - Well-being

UR - http://www.scopus.com/inward/record.url?scp=85117395077&partnerID=8YFLogxK

U2 - 10.1016/j.mhp.2021.200222

DO - 10.1016/j.mhp.2021.200222

M3 - Journal article

AN - SCOPUS:85117395077

VL - 24

JO - Mental Health and Prevention

JF - Mental Health and Prevention

SN - 2212-6570

M1 - 200222

ER -