The journal of mental health policy and economics
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J Ment Health Policy Econ · Mar 2013
Comparative StudyMeasuring disparities across the distribution of mental health care expenditures.
Previous mental health care disparities studies predominantly compare mean mental health care use across racial/ethnic groups, leaving policymakers with little information on disparities among those with a higher level of expenditures. ⋯ Future studies that conclusively disentangle overuse and appropriate use in these populations are warranted.
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J Ment Health Policy Econ · Dec 2012
Assessing the comparative-effectiveness of antidepressants commonly prescribed for depression in the US Medicare population.
Depression is among the most common chronic illnesses in the US elderly Medicare population, affecting approximately 11.5% of beneficiaries with estimated costs of about USD 65 billion annually. Patients with depression are typically treated with antidepressants - most commonly the Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs vary substantially in their costs, side effect profiles and convenience of use. All these factors might affect medication adherence and subsequently down-stream medical costs. ⋯ Geographic variation in the use of prescription drugs has been underutilized as an instrumental variable in comparative-effectiveness research. Our study demonstrates that it can help to control for selection biases in observational data.
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J Ment Health Policy Econ · Sep 2012
The effect of the US Medicare Part D coverage gaps on medication use among patients with depression and heart failure.
Medication use among Medicare beneficiaries has increased and adherence has improved since the implementation of the Medicare Part D prescription drug benefit in 2006. However, the structure of the benefit, particularly, the coverage gap, is still problematic. It is critical to understand how beneficiaries with coexisting conditions respond to the coverage gap and whether their response differs by type of medications. ⋯ Further studies on how people make medication use decisions in the face of changes in benefits and how the coverage affects non-drug medical outcomes are warranted.
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J Ment Health Policy Econ · Sep 2012
Estimating the costs of psychiatric hospital services at a public health facility in Nigeria.
Information on the cost of mental health services in Africa is very limited even though mental health disorders represent a significant public health concern, in terms of health and economic impact. Cost analysis is important for planning and for efficiency in the provision of hospital services. ⋯ The hospital costs were driven by personnel which reflected the mix of inputs that relied most on technical manpower. The unit cost estimates are significantly higher than the upper limit range for low income countries based on the WHO-CHOICE estimates. Findings suggest a scope for improving efficiency of resource use given the high proportion of fixed costs which indicates excess capacity. Adequate research is needed for effective comparisons and valid assessment of efficiency in psychiatric hospital services in Africa. The unit cost estimates will be useful in making projections for total psychiatric hospital package and a basis for determining the cost of specific neuropsychiatric cases.