scholarly journals Cost-effectiveness analysis of interventions to achieve universal health coverage for schizophrenia in Mexico

Salud Mental ◽  
2020 ◽  
Vol 43 (2) ◽  
pp. 65-71
Author(s):  
Héctor Cabello-Rangel ◽  
Lina Díaz-Castro ◽  
Carlos Pineda-Antúnez
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Cost Effectiveness ◽  
Universal Coverage ◽  
Cost Effectiveness Analysis ◽  
Psychosocial Treatment ◽  
Income Quintile ◽  
Health Coverage ◽  
Effectiveness Analysis ◽  
Early Intervention In Psychosis

Introduction. To achieve universal coverage in mental health, it is necessary to demonstrate which interventions should be adopted. Objective. Analyze the alternatives of pharmacological and psychosocial treatment in Mexico for patients diagnosed with schizophrenia, as well as Early Intervention in Psychosis Program. Method. The Extended cost effectiveness analysis (ECEA), it is implemented under scenario the option of treatment in Mexico, which includes: typical or atypical antipsychotic medication plus psychosocial treatment, assuming that all the medications will be provided to the patient, a measure of effectiveness is the years of life adjusted to disability (DALYs). Results. The effect of Universal Public Financing (UPF) is reflected in avoiding 147 DALYs for every 1,000,000 habitants. In addition, has a positive effect in the avoided pocket expenditures from US $ 101,221 to US $ 787,498 according to the type of intervention. Increasing government spending has a greater impact on the poorest quintile, as a distributive effect of the budget is generated. Respect to the value of insurance, the quintile III is the one who is most willing to pay for having insurance, on the other hand, in the highest income quintile, the minimum assurance valuation was observed. Discussion and conclusion. The reduction in out-of-pocket spending is uniform across all quintiles; “Early Intervention in Psychosis Program” is not viable for middle income countries, as México. The ECEA is a convenient method to assess the feasibility and affordability of mental health interventions to generate information for decision makers.

Intensive Case Management: A Cost-Effectiveness Analysis

1998 ◽  
Vol 32 (4) ◽  
pp. 551-559 ◽  
Author(s):  
Susan Johnston ◽  
Glenn Salkeld ◽  
Kristy Sanderson ◽  
Catherine Issakidis ◽  
Maree Teesson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Health Services ◽  
Case Management ◽  
Cost Effectiveness Analysis ◽  
Additional Patient ◽  
Intensive Case Management ◽  
Management Group ◽  
Effectiveness Analysis ◽  
Clinically Significant

Objective: The objective of this study was to compare the outcomes and costs of intensive case management with routine case management for a group of severely disabled patients with a mental illness. Method: A cost-effectiveness analysis was conducted alongside a randomised con trolled trial. Seventy-three patients, who reside in the eastern suburbs of Sydney, were randomly allocated to either intensive or routine case management. Staff pro viding intensive case management had substantially lower caseloads than staff pro viding routine case management. The main health outcome measured was patients' level of functioning as measured by the Life Skills Profile. Costing data were collect ed from hospital services, mental health services, general health services, community services and informal carers. Results: At 12 months, outcome and costing data were analysed on 58 patients and hospitalisation data were analysed on 68 patients. Significantly more patients in the intensive case management group remained in treatment (χ2 = 6.00, df = 1, p < 0.01) and showed a clinically significant improvement in functioning from base line to 12 months (χ2 = 4.50, df = 1, p < 0.05). The mean cost per patient was $7745 more in the intensive group than in the routine group (t = 1.49, df = 56, p > 0.01) over 12 months. The cost-effectiveness ratio indicated a cost of $27 661 per year for one additional patient in the intensive case management group to make a clinically significant improvement in functioning. Conclusion: Intensive case management led to an increased rate of retention in treatment and a clinically significant improvement in functioning. Further comparative cost-effectiveness studies are required to determine whether $27 661 per year for one patient to make a clinically significant improvement in functioning is a cost-effective use of mental health resources.

Cost-Effectiveness Analysis in Mental Health

1986 ◽  
Vol 5 (1) ◽  
pp. 77-88
Author(s):  
Sue M. Weinstein
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Evaluation Model ◽  
Decision Rules ◽  
Data Gathering ◽  
Mental Health Program ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Mental Health Settings ◽  
Economic Evaluation Model

As costs rise and demands for services increase, governments are beginning to insist that mental health program administrators demonstrate that they are “worthwhile” in terms of results produced (outcomes) for money invested (costs). Cost-effectiveness analysis, one economic evaluation model, is presented as a potentially useful tool that can be employed in mental health settings. An overview of the definition, underlying assumptions, and procedures of cost-effectiveness analysis is provided. Issues relating to the manner in which cost and effectiveness information is presented to decision makers along with associated decision rules are also reviewed. It is concluded that it is difficult to “buy” the cost-effectiveness model as it now exists. Modifications in its assumptions, data gathering and data combination techniques are warranted so that the model can be applicable to mental health settings and policies. The general theme underlying suggested modifications is that values and constraints associated with all aspects of a cost-effectiveness problem must be made explicit and should guide analytic procedures.

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