The Impact of Integrating Mental and General Health Services on Mental Health's Share of Total Health Care Spending in Alberta

Block, Ray; Slomp, Mel; Patterson, Sandy; Jacobs, Philip; Öhinmaa, Arto; Yim, Rita; Dewa, Carolyn S.

doi:10.1176/ps.2008.59.8.860

Cited by 2 publications

(1 citation statement)

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“…Although prior research has found that the cost of managing schizophrenia is higher than other chronic diseases, 35 our findings suggest that the direct costs of schizophrenia are expanding at a greater rate than overall healthcare spending in the province. Mental health spending has historically been underrepresented in healthcare budgets 36 so at first glance increased spending on patients is promising. However, spending per capita remained stagnant over the 10-year period.…”

Section: Discussionmentioning

confidence: 99%

10-Year Trends in Healthcare Spending among Patients with Schizophrenia in Alberta, Canada

et al. 2022

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Objectives Schizophrenia is characterized by high levels of disability often resulting in increased healthcare utilization and spending. With expanding healthcare costs across all healthcare sectors, there is a need to understand how healthcare spending has changed over time. We conducted a population-based study using administrative health data from Alberta, Canada, to describe changes in medical complexity and direct healthcare spending among patients with schizophrenia over a 10-year period. Methods A serial cross-sectional study from January 1, 2008, to December 31, 2017, was conducted to determine changes in demographic characteristics, medical complexity, and costs among all adults (18 years or older) with schizophrenia. Total healthcare spending and sector-specific costs attributable to hospitalizations, emergency department visits, practitioner billings, and prescriptions were calculated and compared over time. Results Over the 10-year period the contact prevalence of patients with schizophrenia increased from 0.6% ( n = 16,183) to 1.0% ( n = 33,176) within the province. There was a marked change in medical complexity with the number of patients living with 3 or more comorbidities increasing from 33.0% to 47.3%. Direct annual healthcare costs increased 2-fold from 321 to 639 million CAD (493 million USD) with a 7-fold increase in medication expenditures over the 10-year time frame. As of 2017, spending on pharmaceutical treatment surpassed hospitalizations as the leading spending category in this population. Conclusions Healthcare spending among patients with schizophrenia continues to increase and may be partially attributable to growing rates of multimorbidity within this population. Although promising second-generation antipsychotic medications have entered the market, this has resulted in considerable changes in the distribution of healthcare spending over time. These findings will inform policy discussions around resource allocation and efforts to curb health spending while also improving care for patients with schizophrenia.

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Section: Discussionmentioning

confidence: 99%

10-Year Trends in Healthcare Spending among Patients with Schizophrenia in Alberta, Canada

et al. 2022

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Depression Care for Low-Income, Minority, Safety Net Clinic Populations With Comorbid Illness

Ell

Lee

Xie

2010

Research on Social Work Practice

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Objective: Increasingly, mental health care is provided within the general health care sector. Accompanying this significant change is the demand for evidence-based as well as cost-effective or cost-neutral care models. Method: The authors present a pooled analysis of three large randomized clinical trials in which social workers provide depression care in collaboration with patient navigators, treating physicians, and consulting psychiatrists to examine the effects of diverse depression interventions on symptom improvement among low-income minority populations with cancer or diabetes in public safety net care systems. Results: Pooled results find a significant intervention effect over usual care. Results also find stronger benefits of structured psychotherapy and or antidepressant medication (AM) over brief counseling and referral to mental health care. Conclusion: The rapid change in health care delivery underscores an urgent mandate for social work to significantly increase its comparative effectiveness clinical trial research and adapt its mental and health care education.

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The Impact of Integrating Mental and General Health Services on Mental Health's Share of Total Health Care Spending in Alberta

Abstract: Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.

Cited by 2 publications

References 5 publications

10-Year Trends in Healthcare Spending among Patients with Schizophrenia in Alberta, Canada

10-Year Trends in Healthcare Spending among Patients with Schizophrenia in Alberta, Canada

Depression Care for Low-Income, Minority, Safety Net Clinic Populations With Comorbid Illness

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