scholarly journals Health economics in mental health. 2: Economic evaluation

1997 ◽  
Vol 21 (11) ◽  
pp. 687-691
Author(s):  
Neil Craig ◽  
Cameron Stark
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Economic Evaluation ◽  
Health Economics ◽  
Economic Analysis ◽  
Mental Health Care ◽  
Costs And Benefits ◽  
Key Concepts ◽  
Different Types ◽  
Key Aspects

This paper is the second in a series explaining key concepts and techniques used in health economics in the context of mental health care. The paper describes the different types of economic analysis and the circumstances in which they should be used. It explains key aspects of the methods used in economic evaluation to measure costs and benefits. The purpose of the paper is not to enable clinicians to undertake economic analysis, but to familiarise them with the methods used in economic evaluation and to enable them to assess the rigour and results of published studies.

scholarly journals Health economics in mental health. 1: Principles

1997 ◽  
Vol 21 (11) ◽  
pp. 684-686 ◽  
Author(s):  
Neil Craig ◽  
Cameron Stark
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Economic Evaluation ◽  
Health Economics ◽  
Mental Health Care ◽  
Resource Use ◽  
Opportunity Cost ◽  
Ethical Argument ◽  
Key Points ◽  
Key Concepts

This is the first of two papers which summarise key concepts in health economics and explains the differences in the various types of economic evaluation published in the economics literature. Examples from the economic analysis of mental health care are used to illustrate the key points. This paper explains the concepts of scarcity, rationing, opportunity cost and efficiency from a health economics perspective, and presents an ethical argument for the use of health economics in making decisions on resource use in mental health care.

Psychiatrists’ views on different types of advance statements in mental health care in Germany

2018 ◽  
Vol 64 (8) ◽  
pp. 737-744 ◽  
Author(s):  
Astrid Gieselmann ◽  
Alfred Simon ◽  
Jochen Vollmann ◽  
Bettina Schöne-Seifert
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Different Types ◽  
Advance Statements

scholarly journals Translating knowledge to practice: optimizing the use of guidelines

2012 ◽  
Vol 21 (3) ◽  
pp. 231-236 ◽  
Author(s):  
A. R. Gagliardi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Decision Making ◽  
Mental Health Care ◽  
Care Delivery ◽  
Guideline Implementation ◽  
Health Care Decision ◽  
Key Concepts ◽  
Care Guidelines ◽  
Care Decision

Guidelines support health care decision-making but continue to be underused, therefore more research is needed on how they can be better developed and implemented. The same is true of mental health care, for which there is recent growing interest in improving care delivery and associated outcomes by optimizing the use of mental health care guidelines. This editorial describes the key concepts from accumulated research on guideline implementation to suggest a number of avenues for research on implementation of mental health care guidelines.

scholarly journals Scaling-up a New Socio-mental Health Service Model in Iran to Reduce Burden of Neuropsychiatric Disorders: An Economic Evaluation Study

2020 ◽  
Author(s):  
Seyede Sedighe Hosseinijebeli ◽  
Aziz Rezapour ◽  
Ahmad Hajebi ◽  
Maziar Moradi Lakeh ◽  
Behzad Damari
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Economic Evaluation ◽  
Mental Health Service ◽  
Mental Health Care ◽  
Scaling Up ◽  
Service Model ◽  
Healthy Life ◽  
Healthy Life Years ◽  
Life Years

Abstract Background The integration of core packages of mental health care into routine primary health care has been introduced as an effective way to achieve universal health coverage in mental health care. Based on the transition of mental health care in Iran, from introducing basic mental health care in PHC to the experience of community-based mental health centers for urban areas, a new socio-mental health service model has been so far proposed. This study aimed to estimate the impact of scaling-up the new socio-mental health model at the national level as well as its associated costs. Methods This study was an economic evaluation following One Health Tool methodology. The data required for the study were collected in the first quarter of the year 2020 with a time horizon from 2020 to 2030. The selected metric for summarizing health effects is healthy life years gained. Resources used in terms of drug and supply, staff salaries and outpatient visits were documented and associated costs were subsequently estimated in order to estimate the average cost of each intervention per case. Results The health impacts are calculated in terms of healthy life years gained for 2020-30, after adjusting the prevalence and incidence rates for each disorder. In total, 1,702,755 healthy life years were expected to be gained. Considering total 1,913,325,408 US dollars cost in base case scenario, each healthy life years gained will cost around 1124 US dollars. Based on the WHO criteria for cost-effectiveness threshold, all of the values ranged from 1042 to 1150 US dollars obtained through eight different scenarios were considered as cost-effective given the GDP per capita of 5506 US dollars for Iran in 2019. Conclusions The present study provided a timely analysis as the ministry of health in Iran sought to implement an ambitious plan of mental care scaling-up across the country. Therefore, this work could make a useful contribution to state-level deliberations on the implementation of this plan. Expanding such works beyond the mental health to all non-communicable diseases and making comparisons between packages of cares can be thus great evidence while the programs are aimed to be scaled-up.

Cost and cost-effectiveness of StepCare: A stepped mental health care service in Australian general practice. (Preprint)

2019 ◽  
Author(s):  
Penny Reeves ◽  
Zoe Szewczyk ◽  
Nyree Gale ◽  
Josephine Anderson ◽  
Jennifer Nicholas ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Practice ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Mental Health Care ◽  
Incremental Cost ◽  
Usual Care ◽  
Implementation Study ◽  
Active Screening

BACKGROUND The online ‘StepCare’ Service identifies adults with common mental disorders, recommends evidence-based treatments and monitors symptoms and risk, with feedback to patient and GP. Proof of concept study data indicated that the Service is acceptable and feasible in general practice. OBJECTIVE As part of a larger implementation study of StepCare, we conducted an economic evaluation of the Service from multiple stakeholder perspectives. The economic evaluation included (1) a trial-based cost and cost effectiveness analysis and (2) a modelled cost-consequence analysis. An Australian public finance perspective was used, with costs disaggregated to give transparency to the investment contributed by the various stakeholders. METHODS General practices, GPs, practice staff and adult patients (18 years and over) in two large Australian Primary Health Networks (PHNs), one urban, the other rural/remote, were invited to take part in the full implementation study. For the trial-based analysis, an incremental cost-effectiveness ratio (ICER) was calculated based on one of two metrics identified as appropriate proxy measures for better alignment with stepped mental health care: GP diagnosis rate for anxiety and depression. The expected costs over a twelve-month period associated with usual practice compared to a fully implemented stepped care model were calculated in the modelled extrapolation. RESULTS The trial-based analyses calculated the incremental cost of implementing StepCare to be $54 per person screened, with a cost per newly diagnosed person of $10,750. The modelled evaluation calculated that over a 12 month period, the StepCare Service (screening and treatment) was associated with mean costs of $294 AUD per person compared to (i) usual care assuming no active screening and a quasi-stepped approach to treatment, costing a mean of $535 AUD per person and (ii) usual care assuming no active screening and treatment-as-usual (ie not quasi-stepped) costing a mean of $442 AUD per person. That is, StepCare was associated with lower costs than either of the two comparator scenarios. CONCLUSIONS Compared to current mental health care in general practice, StepCare is a cost-effective screening and patient management tool.

Economic Evaluations in the Canadian Mental Health System II: From Theory to Practice in Mental Health Care*

1989 ◽  
Vol 34 (7) ◽  
pp. 637-640 ◽  
Author(s):  
Bruce J. Fried ◽  
Catherine Worthington ◽  
Raisa B. Deber
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Economic Evaluation ◽  
Mental Health Care ◽  
Economic Evaluations ◽  
Community Based ◽  
Basic Approaches ◽  
Economic Analyses ◽  
Health Field ◽  
Study Setting

This paper follows from a previous paper which described the basic approaches to economic evaluation of health programs. The discussion in this paper builds and discusses the theoretical and practical concerns felt by practitioners and analysts about economic evaluations in mental health care. Two examples of economic evaluations that compare the costs of hospital care and community-based care are presented to illustrate some of the limitations of economic evaluation. Discussion also focuses on the difficulties involved in developing and conducting economic analyses in the mental health field, as well as problems faced in trying to generalize from one study setting to others.

The Role of Economic Evaluation in Mental Health Care

2001 ◽  
Vol 35 (1) ◽  
pp. 104-117 ◽  
Author(s):  
Bruce Singh ◽  
Graeme Hawthorne ◽  
Theo Vos
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Economic Evaluation ◽  
Mental Health Care ◽  
Resource Constraints ◽  
Psychiatric Treatment ◽  
Burden Of Illness ◽  
Economic Evaluations ◽  
Public Health Medicine ◽  
Basic Principles

Objective: A consequence of the integration of psychiatry into acute and public health medicine is that psychiatrists are being asked to evaluate their services. There is pressure on mental health-care systems because it is recognized that funds should be directed where they can provide the best health outcomes, and also because there are resource constraints which limit our capacity to meet all demands for health care. This pressure can be responded to by evaluation which demonstrates the effectiveness and efficiency of psychiatric treatment. This paper seeks to remind psychiatrists of the fundamental principles of economic evaluation in the hope that these will enable psychiatrists to understand the methods used in evaluation and to work comfortably with evaluators. Method: The paper reviews the basic principles behind economic evaluation, illustrating these with reference to case studies. It describes: (i) the cost of the burden of illness and treatment, and how these costs are measured; (ii) the measurement of treatment outcomes, both as changes in health status and as resources saved; and (iii) the various types of economic evaluation, including cost-minimization, cost-effectiveness, cost-utility and cost–benefit analysis. Results: The advice in the paper provides psychiatrists with the necessary background to work closely with evaluators. A checklist of the critical questions to be addressed is provided as a guide for those undertaking economic evaluations. Conclusions: If psychiatrists are willing to learn the basic principles of economic evaluation and to apply these, they can respond to the challenges of evaluation.

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