The journal of mental health policy and economics
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J Ment Health Policy Econ · Jun 2014
Priority setting in the Austrian healthcare system: results from a discrete choice experiment and implications for mental health.
The impact of mental conditions is expected to be among the highest ranked causes of illness in high income countries by 2020. With changing health needs, policy makers have to make choices in an environment with increasingly constrained resources and competing demands. Discrete choice experiments have been identified as a useful approach to inform and support decision-making in health care systems and, in particular, its rationing. ⋯ Based on system-wide generic decision making criteria, mental health is shown to be a top priority for Austria. Preference-based approaches might offer complementary information to policymakers in priority setting decisions and a useful tool to support rationale rather than ad hoc decision-making.
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J Ment Health Policy Econ · Jun 2014
Randomized Controlled TrialCost-effectiveness of a randomized trial to treat depression among Latinos.
Rising mental health costs have brought with them the pressing need to identify cost-effective treatments. Identifying cost-effective treatments for depression among Latinos is particularly relevant given substantial disparities in access to depression treatment for Latinos compared to non-Latino whites. ⋯ The finding that phone-based intervention is able to improve the depressive symptoms of patients just as effectively as face-to-face by spending less is crucial for policy makers and health institutions looking to adopt cost-effective depression treatments.
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J Ment Health Policy Econ · Jun 2014
Mental health care system optimization from a health-economics perspective: where to sow and where to reap?
Health care expenditure (as % of GDP) has been rising in all OECD countries over the last decades. Now, in the context of the economic downturn, there is an even more pressing need to better guarantee the sustainability of health care systems. This requires that policy makers are informed about optimal allocation of budgets. We take the Dutch mental health system in the primary care setting as an example of new ways to approach optimal allocation. ⋯ The model can be used to guide health care system innovation, by identifying those parameters where changes in the uptake, compliance, effectiveness and costs of interventions have the largest impact on the cost-effectiveness of a mental health care system overall. In this sense, the model could assist policy makers during the first stage of decision making on where to make improvements in the health care system, or assist the process of guideline development. However, the improvement candidates need to be assessed during a second-stage 'normative filter', to address considerations other than cost-effectiveness.
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J Ment Health Policy Econ · Jun 2013
Cost-effectiveness of alternative treatments for depression in low-income women.
Low-income mothers are more likely to experience depressive symptoms than their higher income counterparts, but they are less likely to receive treatment. One way to overcome common barriers to care for low-income women is to do therapy in the mother's home. ⋯ In coming years, the number of low-income women covered by public insurance should increase due to the Affordable Care Act. Given the high prevalence of depression in this population, it will be important to consider the value of potential resources spent on depression treatments. This study found that both in-home IPT and medication could be cost-effective treatments for depression. The results of this study support public payers reimbursing for in-home services.
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Schizophrenia is a disabling psychiatric disorder that has severe consequences for patients and their families. Moreover, the expensive treatment of schizophrenia imposes a burden on health care providers and the wider society. Existing cost estimates for Sweden, however, are based on relatively small patient populations and need to be confirmed in a large register-based study. ⋯ The major strengths of the study are the relatively large sample, and the linkage of patient-level clinical data on inpatient and outpatient care with national registry data on prescription pharmaceuticals, and days on social insurance. A limitation was that costs for informal care and primary care were not included in the data, but previous studies suggest that these costs items are small compared to other costs for schizophrenia. IMPLICATIONS FOR HEALTH POLICIES AND FUTURE RESEARCH: Costs were strongly related to hospitalization and GAF, suggesting that attempts to improve global functioning and avoid hospitalizations by means of effective treatment and rehabilitation might not only decrease suffering for patients and relatives, but also reduce the societal cost of schizophrenia. A detailed knowledge of the societal costs can also be helpful in evaluating the cost-effectiveness of new treatment strategies to improve the care for patients with schizophrenia.