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Herron, Robert Emmanuel
The impact of Transcendental Meditation practice on medical expenditures

Order No. 9310427

Despite attempts to contain health care spending, these costs have continued to grow rapidly. Consequently, new strategies are needed. In response to this need, this research evaluated the impact of Maharishi Mahesh Yogi's Transcendental Meditation (TM) program on medical expenditures. Over 500 studies conducted worldwide indicate that TM practice produces a unique state of restful alertness that improves mental and physical health. Biochemical and psychological research shows that TM practice also eliminates stress that degrades the immune system and increases disease susceptibility. Previous cross- sectional research (Orme-Johnson, 1987) found that TM practitioners have lower medical care utilization than nonmeditating control groups. This longitudinal study evaluated the possible effect of TM practice on medical expenditures as measured by payments for physicians' services. In 1991 meditators in Quebec, Canada were mailed questionnaires that asked for their health insurance number that enabled the government to retrieve the monthly physicians' expenses from 1981-1990 for 599 subjects. A mail survey of nonrespondents was also conducted. The data was controlled for age, sex, inflation (physicians' fee index), year-specific variation and season, and was analyzed three years before and after subjects started TM practice. During the pretest the physicians' expense differences were nonsignificant between TM subjects and the averages of all enrollees of the same age and sex in the Quebec health insurance plan. During the posttest TM subjects' real (inflation adjusted) expenses declined 12.4% annually over three years (cumulative change: approximately 36%). The sample was subdivided to analyze those who incurred high costs in the pre-TM period regardless of age. During the posttest high-cost cases exhibited real expense declines that averaged 18% annually. This effect is not due to regression to the mean. Subjects over fifty years old were also analyzed, and their real expenses declined 19% annually over three years. There is no evidence of nonresponse bias. A thorough examination of threats to validity did not support an alternative hypothesis. These results support the hypothesis that TM practice reduces medical expenditures. When compared with the cost effectiveness of other health promotion and disease prevention interventions, the TM technique showed superior medical expense reduction capability. Consequently, the Transcendental Meditation program is recommended as a strategy for reducing health care expenditures in high-cost groups that incur the majority of expenses in most populations. ftn Orme- Johnson, D. W. Reference. (1987). Medical Care Utilization and the Transcendental Meditation Program. Psychosomatic Medicine. 49:493-507. Source: DAI, 53, no. 12A, (1993): 4219

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