TY - JOUR
KW - Follow-Up Studies
KW - Great Britain
KW - Health Care Costs
KW - Humans
KW - Mental Disorders/diagnosis/economics/therapy
KW - Mental Health Services/economics/manpower
KW - Primary Health Care/economics
KW - Psychiatric Status Rating Scales
KW - Psychiatry/economics
KW - Questionnaires
KW - Severity of Illness Index
KW - Urban Health Services/economics/manpower
AU - P. McCrone
AU - N. K. Fitzpatrick
AU - E. Mathieson
AU - D. Chisholm
AU - S. Nourmand
A1 - 
AB - BACKGROUND: Providing care for people with serious and enduring mental health problems has been prioritised in a number of countries. It has been recognised that good liaison between primary and secondary care services is required for care to be effective. However, little is known about the resource implications of different levels of 'shared care'. The aim of this study is to compare service use and costs of different levels of shared care between primary and secondary care services. METHOD: Service use data were collected at baseline and one year later for participants with severe mental illness and costs were calculated. Levels of shared care were categorised into low, medium and high tertiles. Comparisons were made between the groups using multivariate analysis to control for participant characteristics. RESULTS: Participants receiving a low level of shared care used residential care less and were less likely to have contacts with a psychiatrist or social worker than those receiving medium or high levels of shared care. Mean costs for a low level of shared care were significantly lower than for a medium level (a difference of pound 2606, 90% CI pound 452 to pound 4923), but not significantly lower than for a high level of shared care (difference of pound 1867, 90% CI- pound 287 to pound 3903). CONCLUSION: Different levels of shared care are associated with different patterns of service use, with greater resource consumption associated with a medium level of shared care. Further work is required to investigate the causal links between integrated care and service use and costs.
BT - Social psychiatry and psychiatric epidemiology
C5 - Financing & Sustainability
CP - 7
CY - Germany
DO - 10.1007/s00127-004-0780-2
IS - 7
JF - Social psychiatry and psychiatric epidemiology
N2 - BACKGROUND: Providing care for people with serious and enduring mental health problems has been prioritised in a number of countries. It has been recognised that good liaison between primary and secondary care services is required for care to be effective. However, little is known about the resource implications of different levels of 'shared care'. The aim of this study is to compare service use and costs of different levels of shared care between primary and secondary care services. METHOD: Service use data were collected at baseline and one year later for participants with severe mental illness and costs were calculated. Levels of shared care were categorised into low, medium and high tertiles. Comparisons were made between the groups using multivariate analysis to control for participant characteristics. RESULTS: Participants receiving a low level of shared care used residential care less and were less likely to have contacts with a psychiatrist or social worker than those receiving medium or high levels of shared care. Mean costs for a low level of shared care were significantly lower than for a medium level (a difference of pound 2606, 90% CI pound 452 to pound 4923), but not significantly lower than for a high level of shared care (difference of pound 1867, 90% CI- pound 287 to pound 3903). CONCLUSION: Different levels of shared care are associated with different patterns of service use, with greater resource consumption associated with a medium level of shared care. Further work is required to investigate the causal links between integrated care and service use and costs.
PP - Germany
PY - 2004
SN - 0933-7954; 0933-7954
SP - 553
EP - 559
EP - 
T1 - Economic implications of shared care arrangements. A primary care based study of patients in an inner city sample
T2 - Social psychiatry and psychiatric epidemiology
TI - Economic implications of shared care arrangements. A primary care based study of patients in an inner city sample
U1 - Financing & Sustainability
U2 - 15243693
U3 - 10.1007/s00127-004-0780-2
VL - 39
VO - 0933-7954; 0933-7954
Y1 - 2004
ER -