![]() 8 The study provided an important step in cross-national comparisons, but was limited by its exclusive focus on inpatient mental health care and lack of case-mix adjustment. After comparing 32 Organization for Economic Cooperation and Development countries, Moran and Jacobs concluded that Slovenia, Korea, Poland, and Denmark were the most efficient in mental healthcare provision. 7 International comparative efforts have also been made specifically in the mental health field. One study compared the National Health Service of the United Kingdom and Kaiser Permanente, a large staff-model managed care organization in the United States (U.S.), finding that Kaiser patients had fewer acute days per capita and received overall higher quality of care at the same costs. 2, 4– 6 To address this, there have been calls from international health agencies for initiatives to improve access to treatment and to compare efficiency and quality of system models in order to implement evidence-based policy.Ĭross-national comparative analyses of healthcare system efficiency have been carried out in several prior studies to evaluate system differences. 1– 3 Most persons with mental disorders receive no treatment, which is a major public health concern given the impact of mental health on quality of life and subsequent expenditures. Differences in insurance and healthcare system policies and mental health professional roles may explain these dissimilarities.ĭespite the high worldwide prevalence of mental disorders, rates of treatment do not match the need for care and mental health policies are a low priority in most countries. Patients in Madrid were more likely to receive psychotropic medication, had fewer inpatient stays and readmissions, and had lower expenditures, but had lower rates of minimally adequate care. 8.7%) despite higher rates of minimally adequate care (49.5% vs. Boston patients used inpatient services more frequently and had higher 30-day re-admission rates (23.7% vs. Annual total average treatment expenditures were $4,442.14 in Boston and $2,277.48 in Madrid. ![]() Two-part multivariate generalized linear regression and logistic regression models were estimated to identify site differences in mental health care expenditures and quality of care. Data are from 2010–2012 electronic health records from three hospital psychiatry departments in Madrid (n=29,944 person-years) and three in Boston (n= 14,109 person-years). Analyses of healthcare expenditures and adequacy are needed to identify cost-effective policies and practices that improve mental health care quality. ![]()
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