Economic and Organisational Implications of Integrating Clinical Psychology into Primary Care
Abstract
Background: Clinical Psychology (CP) has seen increasing integration into Primary Care (PC) in Spain in recent years, with marked regional differences in implementation, scope and service organisation. However, there is limited evidence on the economic and organisational implications of different models of integration. This study evaluates the economic impact and organisational consequences of consultation-liaison, collaborative, and replacement models incorporating CP professionals into PC teams.
Methods: Economic evidence was identified through an update of a previous review and additional searches in general and specialised economic databases (2010 to 2025). Economic evaluations and cost and resource use studies of organisational models incorporating CP in PC were included. Outcomes included cost-effectiveness, costs and health benefits (e.g. QALYs). Evidence was synthesised narratively.
Results: Six economic studies were included. Collaborative and mixed collaborative–replacement models increased service use and costs but showed favourable cost-effectiveness versus usual care, with substantial heterogeneity. Collaborative models required structured coordination, case management, symptom monitoring and planned communication between PC and CP professionals. Mixed collaborative–replacement models were more accessible and low-intensity, but involved less formal coordination. Consultation-liaison models were not cost-effective.
Conclusions: Economic evidence is limited and heterogeneous. Collaborative and mixed models appear most promising, although cost-effectiveness varies. Organisationally, implementation requires clear roles, structured referral pathways, coordination mechanisms and adequate resources. Integration of CP in PC alone is unlikely to improve care unless embedded in a structured service model.
Key messages: • Collaborative and mixed models integrating CP in Primary Care may improve outcomes but often increase costs, with variable cost-effectiveness.
• Effective implementation requires clear roles, coordination and resources; CP integration alone is insufficient without a structured care model.
Related
- Effectiveness of organisational models incorporating Clinical Psychology in Primary Care settings
- Clinical similarity, economic divergence: cost-effectiveness and population health implications of dietary, pharmacological, and exercise interventions in older adults with type 2 diabetes: a secondary analysis of a randomized controlled trial.
- The peace and operational psychology debates on counterterrorism: Unanswered questions, lessons learned, and implications for future practice
- Community-based integrated medical and elderly care in Chengdu, China: organisational heterogeneity, service-capacity and service-receipt patterns, and implications for care continuity
- Uptake, Barriers, and Facilitators of Open Science in Clinical Psychology: Findings from an Exploratory Survey in German-speaking Countries
BibTeX
@article{linares2026economic,
title = {{Economic and Organisational Implications of Integrating Clinical Psychology into Primary Care}},
author = {D Liñares and Y Triñanes-Pego and B Casal-Acción and E Pawlowska-Pawlowska and I Martínez-Montero and M J Faraldo-Vallés},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1057},
url = {https://doi.org/10.1093/eurpub/ckag169.1057},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Economic and Organisational Implications of Integrating Clinical Psychology into Primary Care
AU - D Liñares
AU - Y Triñanes-Pego
AU - B Casal-Acción
AU - E Pawlowska-Pawlowska
AU - I Martínez-Montero
AU - M J Faraldo-Vallés
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1057
UR - https://doi.org/10.1093/eurpub/ckag169.1057
AB - Background: Clinical Psychology (CP) has seen increasing integration into Primary Care (PC) in Spain in recent years, with marked regional differences in implementation, scope and service organisation. However, there is limited evidence on the economic and organisational implications of different models of integration. This study evaluates the economic impact and organisational consequences of consultation-liaison, collaborative, and replacement models incorporating CP professionals into PC teams. Methods: Economic evidence was identified through an update of a previous review and additional searches in general and specialised economic databases (2010 to 2025). Economic evaluations and cost and resource use studies of organisational models incorporating CP in PC were included. Outcomes included cost-effectiveness, costs and health benefits (e.g. QALYs). Evidence was synthesised narratively. Results: Six economic studies were included. Collaborative and mixed collaborative–replacement models increased service use and costs but showed favourable cost-effectiveness versus usual care, with substantial heterogeneity. Collaborative models required structured coordination, case management, symptom monitoring and planned communication between PC and CP professionals. Mixed collaborative–replacement models were more accessible and low-intensity, but involved less formal coordination. Consultation-liaison models were not cost-effective. Conclusions: Economic evidence is limited and heterogeneous. Collaborative and mixed models appear most promising, although cost-effectiveness varies. Organisationally, implementation requires clear roles, structured referral pathways, coordination mechanisms and adequate resources. Integration of CP in PC alone is unlikely to improve care unless embedded in a structured service model. Key messages: • Collaborative and mixed models integrating CP in Primary Care may improve outcomes but often increase costs, with variable cost-effectiveness. • Effective implementation requires clear roles, coordination and resources; CP integration alone is insufficient without a structured care model.
SN - 1101-1262
SN - 1464-360X
ER -