Quality of Life, Healthcare Use and Cost of Practice From a Nationally-Representative Australian Survey to Inform Future Economic Evaluations of Contemplative Practices

Abstract Objectives The prevalence of mental health disorders globally is increasing, and contemplative practices (such as meditation/mindfulness) are recommended by many health professionals to address this issue. These practices now need to be carefully evaluated for safety, effectiveness, and cost-effectiveness. We aimed to investigate key data to inform future economic evaluations in this area via a cross-sectional, nationally representative survey of the Australian population.

Method: We compared quality-of-life scores across groups using regression analysis to account for group differences. Self-reported health service use (general, mental, complementary) was compared across groups (not needed, unmet need, used service) and index-scores. Self-reported practice cost estimates were investigated across contemplative practices (e.g. meditation, yoga) for a range of cost types (e.g. classes, travel, donations).

Results: The sample included 445 meditators, 1034 other contemplative practitioners and 586 non-practitioners, with large demographic differences between groups. Unadjusted quality-of-life scores were significantly higher for non-practitioners compared to practitioners. Differences were maintained when demographic variables were added to the model, but not when mental health service use was included as a covariate. We estimated that 8.9% of the sample had unmet mental-health service need and that this was highest in the meditation group (13.9%) compared to the non-practitioner group (2.4%). The average cost of any contemplative practice (including meditation) was estimated at $1,281 per person.

Conclusions: This study provides preliminary evidence on potentially suitable variables for estimating costs and effects for conducting cost-effectiveness studies of contemplative practices. EQ-HWB-9 index scores performed well as an outcome measure in this population. Preregistration The initial study was preregistered at Open Science Framework osf.io/etkh4. The current paper is additional to the preregistered research questions.