Mindfulness-Based Stress Reduction in an Integrated Care Delivery System: One-Year Impacts on Patient-Centered Outcomes and Health Care Utilization
Open accessAbstract
BACKGROUND: Mindfulness-based stress reduction (MBSR) programs have demonstrated clinical effectiveness for both mental and physical health conditions. Less research exists on health services utilization, self-efficacy, or work productivity outcomes. OBJECTIVE: To assess one-year outcomes of MBSR in patients with chronic pain, chronic illness, or stress-related problems, measuring functional status, pain, self-efficacy, depression, anxiety, somatization, psychological distress, work productivity, and changes in health services utilization. METHODS: A prospective single cohort design evaluated an eight-week MBSR program for Kaiser Permanente Colorado members. Patient-reported measures were collected at baseline, eight weeks, and one year following MBSR. Differences in health services utilization were compared from six months before MBSR to six months following the one-year anniversary of MBSR. RESULTS: Most of the 38 participants were white (28; 74%), female (30; 79%), employed part-time (35; 92%), and average age 52.6 years, with multiple comorbidities (averaging 16.4 unique diagnoses), the most common being joint or back pain (28; 74%) and psychological disorder (20; 53%). Repeated measures analyses at 8 weeks (n = 26) and at 1 year (n = 24) showed significant improvements in self-reported mental and physical function, pain, psychological symptoms, and self-efficacy, but not work productivity. Significant decreases at 1 year were observed for visits in primary care (-50%, p < 0.0001), specialty care (-38%, p = 0.0004), and the Emergency Department (-50%, p = 0.04), and for hospital admissions (-80%, p = 0.02). CONCLUSION: The MBSR program was associated with improvements in several patient-centered outcomes over 1 year and reductions in health services utilization up to 18 months.
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Preliminary evidence links MBIs to reduced ED visits and/or hospitalizations in community samples.
“Regarding MBIs, associations have been reported between MBCT and reduced nonmental health ED visits,61 between mindfulness-based stress reduction and decreased ED visits and hospitalizations for medical and psychiatric reasons,62 and between a novel MBI and decreased psychiatric hospitalizations among individuals with schizophrenia63 in community samples.”
From Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders (2019) · cites this paper as [62]
The Results report significantly fewer Emergency Department visits and hospital admissions after MBSR, and the Discussion describes the participants as a heterogeneous population in a community care setting. The utilization results do not distinguish visits or admissions for medical versus psychiatric reasons, so that detail in the citing sentence is unsupported. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMindfulness was associated with improvements in patient-centered outcomes for over a year after initial intervention.
“McCubbin et al. demonstrated that mindfulness was associated with improvements in patient-centered outcomes for over a year after initial intervention and with a reduced utilization of healthcare services for up to 18 months [68].”
From Identification and Management of Chronic Pain in Primary Care: a Review (2016) · cites this paper as [68]
Mindfulness was associated with reduced utilization of healthcare services for up to 18 months.
“McCubbin et al. demonstrated that mindfulness was associated with improvements in patient-centered outcomes for over a year after initial intervention and with a reduced utilization of healthcare services for up to 18 months [68].”
From Identification and Management of Chronic Pain in Primary Care: a Review (2016) · cites this paper as [68]
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- Authors
- McCubbin, T., Dimidjian, S., Kempe, K., Glassey, M. S., Ross, C., & Beck, A.
- Affiliations
- Kaiser Permanente (US)
- University of Colorado Boulder (US)
- Venue
- The Permanente Journal
- Publisher
- The Permanente Federation
- Published
- 2014-12
- Volume
- 18
- Issue
- 4
- Pages
- 4-9
- ISSN
- 1552-5767 (ISSN-L)
- 1552-5775
- PMC
- PMC4206164
- OpenAlex
- W2108930223
- Cited by
- 26
- References
- 30
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 1
- FWCI
- 2.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Permanente Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- mindfulness-based stress reduction, health care utilization, patient-centered outcomes, chronic pain, chronic disease, self-efficacy, depression, anxiety, somatization, psychological distress, labor productivity, hospitalization, emergency department visits, Kaiser Permanente, integrated care
- MeSH terms
- Female, Health Services, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Stress, Psychological, Patient-Centered Care, Delivery of Health Care, Integrated, Mindfulness
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