The journal of mental health policy and economics
-
J Ment Health Policy Econ · Jun 2006
Multicenter StudyModeling costs and burden of informal caregiving for persons with bipolar disorder.
Informal caregiving contributes significantly to the health and well being of chronically ill persons. While a vast literature demonstrates this connection, the cost and financial burden of informal caregiving has received considerably less research attention, especially as it-pertains to bipolar disorder. ⋯ Caution is needed in estimating the costs of informal caregiving needs as many costs are possible but their relationship to burden varies in strength and significance. Assumptions related to what is given and received and how this relates to expected patterns of giving and receiving in measuring and determining financial burden and costs are particularly important, as is the valuation of time.
-
Depression is one of the most disabling diseases, and causes a significant burden both to the individual and to society. WHO data suggests that depression causes 6% of the burden of all diseases in Europe in terms of disability adjusted life years (DALYs). Yet, the knowledge of the economic impact of depression has been relatively little researched in Europe. ⋯ This study has identified several research gaps which are of interest for future research. In order to better understand the impact of depression to European society long-term prospective epidemiology and cost-of-illness studies are needed. In particular data is lacking for Central European countries. On the basis of our findings, further economic evaluations of treatments for depression are necessary in order to ensure a cost-effective use of European healthcare budgets.
-
J Ment Health Policy Econ · Dec 2005
Labor market, financial, insurance and disability outcomes among near elderly Americans with depression and pain.
The economic burden of depression has been documented, but the role of comorbid conditions is unclear. Depression and comorbid pain are particularly common, are associated with worse clinical outcomes and require different care than "pure'' depression. Does this comorbidity account for a large share of the adverse social outcomes attributed to depression? ⋯ Further research should focus on causality of depression and comorbid pain on economic outcomes. Depression research should consider the heterogeneity of this disorder in outcomes assessment.
-
J Ment Health Policy Econ · Sep 2005
Comparative StudyRacial disparities in prescription drug use for mental illness among population in US.
Racial minorities are a rapidly growing portion of the US population. Research suggests that racial minorities are more vulnerable to mental illness due to risk factors, such as higher rates of poverty. Given that the burden of mental illnesses is significant, equal likelihood of mental health services utilization is important to reduce such burden. Racial minorities have been known to use mental health services less than Whites. However, it is unclear whether racial disparity in prescription drug use for mental illnesses exists in a nationally representative sample. For a valid estimation of prescription drug use patterns, the characteristic in the distribution of prescription drug use should be accounted for in the estimation model. ⋯ Future research should examine the causes for racial disparity in the use of prescription drugs for mental illness both in the extensive and intensive margins. An in-depth analysis is needed to map out the attributes for the observed disparity between Whites and racial minorities in mental health service use.
-
J Ment Health Policy Econ · Mar 2005
Variation in patient routine costliness in U.S. psychiatric facilities.
The Balanced Budget Refinement Act of 1999 included a Congressional mandate to develop a patient-level case mix prospective payment system (PPS) for all Medicare beneficiaries treated in PPS-exempt psychiatric facilities. Payment levels by case mix category have been proposed by the government based on claims and facility cost reports. Because of claims data limitations, these levels do not account for patient-specific staffing costs within a facility's routine units, nor are certain key patient characteristics considered for higher payment. ⋯ Larger primary samples of special psychiatric units (e.g., med-psych, child/adolescent) could improve estimates of daily routine costliness. Larger samples could also support stronger tests of case mix and cost differences by facility type and teaching status. Medical records information on non-Medicare patients could quantify any systematic differences in average daily costs holding case mix constant. Similar primary studies of psychiatric patients treated outside PPS-exempt units in acute general hospitals could result in a fully integrated payment system for all mentally ill Medicare patients, thereby avoiding payment inefficiencies and inequities.