The journal of mental health policy and economics
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J Ment Health Policy Econ · Jun 2012
Poverty and severe psychiatric disorder in the U.S.: evidence from the Medical Expenditure Panel Survey.
Previous studies have shown that persons with severe psychiatric disorders are more likely to be poor and face disparities in education and employment outcomes. Poverty rates, the standard measure of poverty, give no information on how far below the poverty line this group falls. ⋯ The results point to the need for additional research in a number of areas: trends in poverty for households with severe psychiatric disorders over time; mobility and persistence of poverty for this group; and the association of severe disorder to other, non-monetary dimensions of poverty, such as a lack of social integration.
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J Ment Health Policy Econ · Mar 2012
The relationship of antidepressant prescribing concentration to treatment duration and cost.
Widely accepted treatment guidelines and performance measures encourage patients to stay on antidepressant medication beyond the acute phase of treatment in order to achieve full remission and reduce risk of relapse. However, many patients discontinue antidepressant medication treatment prematurely for various reasons, including side-effects or nonresponse to the initial medication prescribed. Customization of medications to differing patient profiles could potentially improve medication treatment duration, but for many diseases physicians tend to concentrate on a limited subset of available medications. Little is known about the effects of concentration in prescribing on medication treatment duration and expenditures. ⋯ Additional studies are needed to understand what mechanisms may link concentration in prescribing to medication treatment duration and expenditures.
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J Ment Health Policy Econ · Mar 2012
Economic burden of schizophrenia: empirical analyses from a survey in Thailand.
Evidence consistently indicates that schizophrenia is a costly disease although it is not a high prevalence disorder. There are a few studies in developing countries but no study in Thailand reporting the cost of schizophrenia from a societal perspective. Health policy makers need to be aware of the cost of health care for people with schizophrenia as well as the economic burden on patients and families. ⋯ In priority setting it is important that policy makers are aware of the high direct and indirect costs of schizophrenia. Providing optimal treatment (e.g. medication in combination with psychosocial interventions) could reduce some costs such has hospitalization but this may require increased investment in mental health care and time spent by patients and caregivers.
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J Ment Health Policy Econ · Dec 2011
Comparative StudyDoes the EQ-5D measure quality of life in schizophrenia?
Most health economic evaluations in mental care include outcome measures aimed at specific aspects of health, like symptom improvement, functional improvement and quality of life instead of generic preference based outcome measures. The health economic guidelines (NICE) recommend to include a generic preference based outcome measure, like EQ-5D, in health economic evaluations in order to allow for comparisons of health related quality of life of patient groups across different diseases, providing information particular useful to support health policy decisions and cost-effectiveness analysis. Although the EQ-5D is by far the most widespread outcome measure within the context of economic evaluations, its validity in psychiatric populations has not yet been established unambiguously. An increasing number of articles have tested the validity of the EQ-5D in comparisons with clinical measures in mental health, but only few studies have addressed the correlation between the EQ-5D and a condition-specific quality of life measure in mental health. ⋯ Mental health interventions often seek to improve the patients' quality of life in a broader perspective, like improving the patients' relationship with family, friends and other network, financial situation, employment and accommodation. If the EQ-5D is used as a single outcome in health economic evaluations of e.g. mental health community interventions, these factors may be overlooked. Based on a relatively small sample, we therefore recommend applying the EQ-5D together with condition-specific quality of life measures in future health economic evaluations in mental health.
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J Ment Health Policy Econ · Sep 2011
National estimates of the inpatient burden of pediatric bipolar disorder in the United States.
Pediatric bipolar disorder (BPD) is a debilitating recurrent chronic mental illness, characterized by cycling states of depression, mania, hypomania, and mixed episodes. Similarly to adults, children and adolescents with BPD are typically treated with pharmacotherapy and adjunctive psychotherapy. Nevertheless, emergency-room visits and hospitalizations are common for those suffering from pediatric BPD. Previous studies have shown declining trends in mean inpatient costs and length of stay (LOS) in the hospital for children with BPD. ⋯ Further studies should be conducted to determine if average LOS and mean hospitalization cost remain consistent with declining trends or whether the increase between 2003 and 2006 represents a trend reversal.