Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?

Minna Sadeniemi, Sami Pirkola, Maiju Pankakoski, Grigori Joffe, Raija Kontio, Maili Malin, Taina Ala-Nikkola and Kristian Wahlbeck
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Minna Sadeniemi: Department of Psychiatry, Hospital District of Helsinki and Uusimaa, Porvoo Health Care Area, Porvoon psykiatrian poliklinikka, Kaivokatu 37, FI-06100 Porvoo, Finland
Sami Pirkola: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland
Maiju Pankakoski: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland
Grigori Joffe: Department of Psychiatry, University Hospital Region, Hospital District of Helsinki and Uusimaa, Välskärinkatu 12, PL 590, FI-00029 HUS, Finland
Raija Kontio: Department of Psychiatry, Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Vanha Valtatie 198, FI-04500 Kellokoski, Finland
Maili Malin: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland
Taina Ala-Nikkola: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland
Kristian Wahlbeck: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland

IJERPH, 2014, vol. 11, issue 9, 1-12

Abstract: Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration.

Keywords: costs and cost analysis; primary health care; nurses; psychiatric hospitals (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2014
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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