scholarly journals Impact of mental illness on in-patient hospital costs for somatic disorders and associated factors

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Michel ◽  
A J Hammami ◽  
K Chevreul
Keyword(s):  
Primary Care ◽  
Health Promotion ◽  
Mental Illness ◽  
Mental Disorders ◽  
Economic Burden ◽  
Mentally Ill ◽  
Hospital Costs ◽  
Healthcare Systems ◽  
Interaction Terms

Abstract Background People suffering from mental disorders are in poorer somatic health that the general population. This is due in part to poor quality of care in primary care settings, which can in turn have a major impact on hospitals and healthcare systems, in particular in terms of costs. Our objective was to assess the economic burden of acute care admissions for somatic diseases in patients with a mental illness compared to other patients and analyse the factors associated with it. Methods An exhaustive study using French hospital discharge databases was carried out between 2009 and 2013. Total acute hospital costs were calculated from the all payer perspective (statutory health insurance, private health insurances and patient out-of pocket payments). A multivariate regression modelled the association between mental illness and hospital costs while adjusting for other explanatory variables, with and without interaction terms. Results 37,458,810 admissions were included in the analysis. 1,163,972 patients (6.54%) were identified as being mentally ill. Mean total hospital costs at five years per patient were €8,114. Costs per mentally ill patient were on average 34% higher than for a non-mentally patient (€10,637 vs. €7,949). A longitudinal analysis of costs showed a widening of the gap between the two groups as time went by, from 1.60% in 2009 to 10.51% in 2013. In the multivariate model, mental disorders were significantly associated with increased costs, and interaction terms found an increased impact of mental illness on costs in deprived patients. Conclusions Improving quality of primary care and health promotion in people with a mental illness both for their own sake and to decrease the economic burden on the healthcare system, is of vital importance. Key messages There is a significant increase in hospital costs for somatic care in patients with a mental illness compared to other patients, in particular in patients who are also deprived. It is necessary to improve primary care and health promotion in mentally ill patients, for their sake and for the sake of healthcare systems.

scholarly journals Impact of mental illness on care for somatic comorbidities in France: a nation-wide hospital-based observational study

2018 ◽  
Vol 28 (5) ◽  
pp. 495-507 ◽  
Author(s):  
J. Gervaix ◽  
G. Haour ◽  
M. Michel ◽  
K. Chevreul
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Mentally Ill ◽  
Hospital Admissions ◽  
Psychiatric Hospitals ◽  
Access To Healthcare ◽  
Hospital Death ◽  
High Severity ◽  
Hospitalised Patients

Aims.People with a mental illness have a shorter lifespan and higher rates of somatic illnesses than the general population. They also face multiple barriers which interfere with access to healthcare. Our objective was to assess the effect of mental illness on the timeliness and optimality of access to healthcare for somatic reasons by comparing indicators reflecting the quality of prior somatic care in hospitalised patients.Methods.An observational nation-wide study was carried out using exhaustive national hospital discharge databases for the years 2009–2013. All adult inpatient stays for somatic reasons in acute care hospitals were included with the exception of obstetrics and day admissions. Admissions with coding errors were excluded. Patients with a mental illness were identified by their admissions for a psychiatric reason and/or contacts with psychiatric hospitals. The quality of prior somatic care was assessed using the number of admissions, admissions through the emergency room (ER), avoidable hospitalisations, high-severity hospitalisations, mean length of stay (LOS) and in-hospital death. Generalised linear models studied the factors associated with poor quality of primary care.Results.A total of 17 620 770 patients were included, and 6.58% had been admitted at least once for a mental illness, corresponding to 8.96% of hospital admissions. Mentally ill patients were more often hospitalised (+41% compared with non-mentally patients) and for a longer LOS (+16%). They also had more high-severity hospitalisations (+77%), were more often admitted to the ER (+113%) and had more avoidable hospitalisations (+50%). After adjusting for other covariates, regression models found that suffering from a mental illness was significantly associated with a worse state for each indicator of the quality of care except in-hospital death.Conclusion.Inadequate primary care of mentally ill patients leads to more serious conditions upon admission to hospital and avoidable hospitalisations. It is, therefore, necessary to improve primary care and prevention for those patients.

scholarly journals Creating a ‘reverse’ integrated primary and mental healthcare clinic for those with serious mental illness

2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Mental Healthcare ◽  
Policy Reforms ◽  
Mental Health Settings ◽  
Primary Care Practitioners

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.

The Myth of the Mentally Ill Artist

2021 ◽  
pp. 126-145
Author(s):  
William Todd Schultz
Keyword(s):  
Mental Illness ◽  
Emotional Disturbance ◽  
Mentally Ill

Chapter 7 examines the actual study findings related to art and mental illness and concludes that this connection has not been decisively established. The chapter looks at popular studies that have attempted to prove that artists disproportionately suffer from mental illness. The author argues that these studies rise or fall based on how they are conducted, or the quality of the research, and proceeds to look closely at this quality question. The author argues something very different from the art–madness equation: that art is rooted not in disorder but in variations of personality. It’s personality that’s predictive, not emotional disturbance. The author concludes by locating the actual source of artist “torture” in the qualities of mind produced by openness.

Improving quality of care for mental illness in an uninsured, low-income primary care population

2007 ◽  
Vol 29 (4) ◽  
pp. 302-309 ◽  
Author(s):  
Larry B. Mauksch ◽  
Randall Reitz ◽  
Suzanne Tucker ◽  
Steve Hurd ◽  
Joan Russo ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Quality Of Care ◽  
Low Income ◽  
Primary Care Population

scholarly journals Biogenetic explanations and public acceptance of mental illness: Systematic review of population studies

2011 ◽  
Vol 199 (5) ◽  
pp. 367-372 ◽  
Author(s):  
Matthias C. Angermeyer ◽  
Anita Holzinger ◽  
Mauro G. Carta ◽  
Georg Schomerus
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mentally Ill ◽  
General Public ◽  
Causal Attributions ◽  
Population Studies ◽  
Public Acceptance ◽  
People With Mental Illness

BackgroundBiological or genetic models of mental illness are commonly expected to increase tolerance towards people with mental illness, by reducing notions of responsibility and blame.AimsTo investigate whether biogenetic causal attributions of mental illness among the general public are associated with more tolerant attitudes, whether such attributions are related to lower perceptions of guilt and responsibility, to what extent notions of responsibility are associated with rejection of people who are mentally ill, and how prevalent notions of responsibility are among the general public with regard to different mental disorders.MethodA systematic review was conducted of representative population studies examining attitudes towards people with mental illness and beliefs about such disorders.ResultsWe identified 33 studies relevant to this review. Generally, biogenetic causal attributions were not associated with more tolerant attitudes; they were related to stronger rejection in most studies examining schizophrenia. No published study reported on associations of biogenetic causal attributions and perceived responsibility. The stereotype of self-responsibility was unrelated to rejection in most studies. Public images of mental disorder are generally dominated by the stereotypes of unpredictability and dangerousness, whereas responsibility is less relevant.ConclusionsBiogenetic causal models are an inappropriate means of reducing rejection of people with mental illness.

scholarly journals A new population-based measure of the economic burden of mental illness in Canada

2008 ◽  
Vol 28 (3) ◽  
pp. 92-98 ◽  
Author(s):  
K.L. Lim ◽  
P. Jacobs ◽  
A. Ohinmaa ◽  
D. Schopflocher ◽  
C.S. Dewa
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Economic Burden ◽  
Population Based ◽  
Health Related Quality ◽  
Work Loss ◽  
Short Term ◽  
Related Quality ◽  
Health Related

This paper presents a comprehensive measure of the incremental economic burden of mental illness in Canada which incorporates the use of medical resources and productivity losses due to long-term and short-term disability, as well as reductions in health-related quality of life (HRQOL), for the diagnosed and undiagnosed population with mental illness. The analysis was based on the population-based Canadian Community Health Survey Cycle 2.1 (2003). For all persons, we measured all health services utilization, longterm and short-term work loss, and health-related quality of life and their dollar valuations, with the economic burden being the difference in dollar measures between the populations with and without mental health problems. In total, the economic burden was $51 billion in 2003. Over one-half was due to reductions in HRQOL. The current accepted practice in economic assessments is to include changes in medical resource use, work loss, and reductions in HRQOL.

QOL in primary care of elderly mentally ill and their caregivers’ well-being

2011 ◽  
Vol 26 (S2) ◽  
pp. 859-859
Author(s):  
N. Tataru ◽  
A. Dicker
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Primary Care ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Well Being ◽  
The Elderly ◽  
Care Staff ◽  
Care Of Elderly

It is difficult to talk about quality of life of elderly with mental disorders. Thus, there appeared serious ethical challenges for psychiatry: to cut mental health costs and to provide care to as many as possible through all duration of their diseases, from the onset to the end-of-life. The psychiatrists have to face these challenges and treat the elderly with or without mental disorders from primary care to residential one, assuring them the best quality of life as it is possible. The goal of medical policy is to optimize the patients’ and their caregivers’ well-being. Multiple loses in old age are important in decreasing of quality of life and increasing of mental health problems in the elderly. They have more social and medical problems, which include depression and suicide. Caring for a family member with dementia can be both challenging and stressful. Primary care-staff need to develop the skills to detect and manage signs of caregivers stress. Health care professionals can promote well-being of the caregivers not only the patients’ well-being, educate them how to access help and manage their stress effectively. Recognition of the importance of the role of caregivers and finding the effective ways of supporting them, respecting their personal perception of the quality of this offer, improve the quality of primary care of elderly patients with mental disorders and also improve the quality of life of their relative or caregivers.

Sign in / Sign up

Export Citation Format

Share Document