Economic evaluation of mental health care interventions. A review.

Due to rising costs, the economic aspects of the mental health care sector are receiving increasing attention. This article scrutinizes 91 published studies in the field of mental health care, applying methodological criteria drawn from epidemiology and economics. The purpose of this study is to provide some insight into the quality of economic evaluation in the field of mental health care. The article shows that few good full economic evaluations studies have been undertaken in the domain of mental health care. One reason for this could be that the measurement of effectiveness in mental health care is complicated because of the known difficulties with the reliability of psychiatric diagnosis and the lack of consensus about the etiology and appropriate treatment for many psychiatric illnesses.

[1]  S. Keith,et al.  The costs of schizophrenia. Assessing the burden. , 1993, The Psychiatric clinics of North America.

[2]  William H. Barker,et al.  CLINICAL EPIDEMIOLOGY: THE ESSENTIALS. , 1984 .

[3]  S. Pocock,et al.  Clinical Trials: A Practical Approach , 1984 .

[4]  P. May Cost efficiency of treatments for the schizophrenic patient. , 1971, The American journal of psychiatry.

[5]  M. Drummond,et al.  Standardizing Methodologies for Economic Evaluation in Health Care: Practice, Problems, and Potential , 1993, International Journal of Technology Assessment in Health Care.

[6]  D. Braddock Community mental health and mental retardation services in the United States: a comparative study of resource allocation. , 1992, The American journal of psychiatry.

[7]  R. Logan,et al.  Clinical Epidemiology: A Basic Science for Clinical Medicine , 1992 .

[8]  D. Wiersma,et al.  Costs and benefits of day treatment with community care for schizophrenic patients. , 1991, Schizophrenia bulletin.

[9]  I. Glick,et al.  A controlled study of transitional day care for non-chronically-ill patients. , 1986, The American journal of psychiatry.

[10]  D. F. Jacobs,et al.  Cost-effectiveness of specialized psychological programs for reducing hospital stays and outpatient visits. , 1987, Journal of clinical psychology.

[11]  M. Knapp,et al.  Service use and Costs of Home-Based Versus Hospital-Based Care for People with Serious Mental Illness , 1994, British Journal of Psychiatry.

[12]  H. Brodaty,et al.  Cost Effectiveness of a Training Program for Dementia Carers , 1991, International Psychogeriatrics.

[13]  E. Struening,et al.  A Comparative Trial of Home and Hospital Psychiatric Treatment: Financial Costs , 1982, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[14]  T. Mcguire,et al.  Economics and Mental Health , 1999 .

[15]  I. Marks,et al.  Cost–benefit analysis of a controlled trial of nurse therapy for neuroses in primary care , 1984, Psychological Medicine.

[16]  J. Tignol,et al.  Cost of anxiety disorders: impact of comorbidity. , 1994, Journal of psychosomatic research.

[17]  A. Elixhauser,et al.  Estimating Costs in the Economic Evaluation of Medical Technologies , 1990, International Journal of Technology Assessment in Health Care.

[18]  P. Marriott,et al.  A Mirror Image Out-Patient Study at a Depot Phenothiazine Clinic* , 1976, The Australian and New Zealand journal of psychiatry.

[19]  M. Cormack,et al.  Evaluation of an easy, cost-effective strategy for cutting benzodiazepine use in general practice. , 1994, The British journal of general practice : the journal of the Royal College of General Practitioners.

[20]  Crisis intervention and the prevention of institutionalization: An interrupted time series analysis , 1978, American journal of community psychology.

[21]  T. Ganiats,et al.  Evaluation of cost-effectiveness research: a survey of recent publications. , 1991, Family medicine.

[22]  M. Drummond,et al.  Assessment of Costs and Benefits of Drug Therapy for Treatment-Resistant Schizophrenia in the United Kingdom , 1993, British Journal of Psychiatry.

[23]  R. C. Grosser,et al.  Estimating clozapine's cost to the nation. , 1990, Hospital & community psychiatry.

[24]  C. Muller,et al.  Economic Costs of Schizophrenia: A Postdischarge Study , 1983, Medical care.

[25]  J. Shapiro,et al.  Cost effectiveness of individual vs. group cognitive behavior therapy for problems of depression and anxiety in an HMO population. , 1982, Journal of clinical psychology.

[26]  K E Warner,et al.  Cost-Benefit and Cost-Effectiveness Analysis in Health Care: Growth and Composition of the Literature , 1980, Medical care.

[27]  F. Song,et al.  Selective serotonin reuptake inhibitors: meta-analysis of efficacy and acceptability. , 1993, BMJ.

[28]  A. Scott,et al.  Edinburgh primary care depression study: treatment outcome, patient satisfaction, and cost after 16 weeks. , 1992, BMJ.

[29]  I. Marks,et al.  Costs and benefits of behavioural psychotherapy: a pilot study of neurotics treated by nurse-therapists , 1977, Psychological Medicine.

[30]  B. Hughes,et al.  A comparison of two different services treating schizophrenia: a cost–benefit approach , 1980, Psychological Medicine.

[31]  Ruth E. Brown,et al.  Cost-effectiveness of clozapine for treatment-resistant schizophrenic patients. , 1990, Hospital & community psychiatry.

[32]  E. Doorslaer,et al.  Economic appraisal of asthma and COPD care: a literature review 1980-1991. , 1992, Social science & medicine.

[33]  L. Koran,et al.  A medical algorithm for detecting physical disease in psychiatric patients. , 1989, Hospital & community psychiatry.

[34]  S. Cellini,et al.  Cost-effectiveness and cost-benefit analysis. , 2015, The Genetic resource.

[35]  J. Gunderson,et al.  The cost of schizophrenia. , 1975, The American journal of psychiatry.

[36]  H. Goldman,et al.  A method for comparing two systems of acute 24-hour psychiatric care. , 1987, Hospital & community psychiatry.

[37]  F. Weaver,et al.  A randomized trial of the cost effectiveness of VA hospital-based home care for the terminally ill. , 1992, Health services research.

[38]  H. Morgenstern,et al.  Epidemiologic Research: Principles and Quantitative Methods. , 1983 .

[39]  M. Knapp,et al.  Community Psychiatric Nurse Teams: Cost-effectiveness of Intensive Support Versus Generic Care , 1994, British Journal of Psychiatry.

[40]  R. Prien,et al.  Intermittent pharmacotherapy in chronic schizophrenia. , 1973, Hospital & community psychiatry.

[41]  B. Weisbrod,et al.  Alternative to mental hospital treatment. II. Economic benefit-cost analysis. , 1980, Archives of general psychiatry.

[42]  S. A. Simmons,et al.  Cost-benefit analysis of prospective pharmacokinetic dosing of nortriptyline in depressed inpatients. , 1985, Journal of affective disorders.

[43]  F. Creed,et al.  Liaison psychiatry in general practice: a comparison of the liaison-attachment scheme and shifted outpatient clinic models. , 1989, The Journal of the Royal College of General Practitioners.

[44]  E. Paykel,et al.  Cost-effectiveness of community psychiatric nurse or out-patient psychiatrist care of neurotic patients , 1983, Psychological Medicine.

[45]  M. W. Linn,et al.  Day Treatment and Psychotropic Drugs in the Aftercare of Schizophrenic Patients: A Veterans Administration Cooperative Study , 1979 .

[46]  S. Sharfstein,et al.  Community care: costs and benefits for a chronic patient. , 1976, Hospital & community psychiatry.

[47]  T. Hu,et al.  Cost-effectiveness of alternative approaches in treating severely mentally ill in California. , 1991, Schizophrenia bulletin.

[48]  R. Hough,et al.  Service utilization and costs of care for severely mentally ill clients in an intensive case management program. , 1995, Psychiatric services.

[49]  D. Kornfeld,et al.  Clinical and cost benefits of liaison psychiatry. , 1981, The American journal of psychiatry.

[50]  A. Maynard The design of future cost-benefit studies. , 1990, American heart journal.

[51]  R. Conley,et al.  An approach to measuring the cost of mental illness. , 1967, The American journal of psychiatry.

[52]  G. Wilkinson,et al.  Psychiatric Morbidity in Primary Health Care a Two-stage Screening Procedure in Developing Countries: Choice of Instruments and Cost-effectiveness , 1987, British Journal of Psychiatry.

[53]  K. Gerard Cost-utility in practice: a policy maker's guide to the state of the art. , 1992, Health policy.

[54]  R. Hamer,et al.  A randomized controlled study of psychiatric consultation guided by screening in general medical inpatients. , 1992, The American journal of psychiatry.

[55]  J. P. Shemo,et al.  Cost-Effectiveness of Providing Mental Health Services: The Offset Effect , 1986, International journal of psychiatry in medicine.

[56]  Lex M. Bouter,et al.  Meta-analyse van therapeutische experimenten II: voorstel tot een protocol , 1990 .

[57]  J. Raftery,et al.  Cost of schizophrenia in a randomized trial of home-based treatment. , 1991, Schizophrenia bulletin.

[58]  D. Sackett Bias in analytic research. , 1979, Journal of chronic diseases.

[59]  A. Vinokur,et al.  Long-term follow-up and benefit-cost analysis of the Jobs Program: a preventive intervention for the unemployed. , 1991, The Journal of applied psychology.

[60]  M. Drummond,et al.  The economic burden of schizophrenia , 1990 .

[61]  A. Burgess,et al.  Rehabilitation of child molesters: a cost-benefit analysis. , 1990, The American journal of orthopsychiatry.

[62]  L. Salvador-Carulla,et al.  Costs and Offset Effect in Panic Disorders , 1995, British Journal of Psychiatry.

[63]  G. Andrews,et al.  The economic costs of schizophrenia. Implications for public policy. , 1985, Archives of general psychiatry.

[64]  M. Isaac,et al.  A Cost-Effectiveness Analysis of Three Different Methods of Psychiatric Case Finding in the General Population , 1980, British Journal of Psychiatry.

[65]  B J McNeil,et al.  Forum: Use and misuse of the term "cost-effective". , 1986, Health cost management.

[66]  B. Karon,et al.  Cost/benefit analysis: Psychologist versus psychiatrist for schizophrenics. , 1976 .

[67]  Susan E. Sheridan,et al.  Implementing a Group Therapy Program in a Managed-Care Setting: Combining Cost Effectiveness and Quality Care , 1992 .

[68]  A. Wimo,et al.  Group living, an alternative for dementia patients. A cost analysis , 1991 .

[69]  B. Snitz,et al.  Cost effectiveness of clozapine in neuroleptic-resistant schizophrenia. , 1993, The American journal of psychiatry.

[70]  G. Honigfeld,et al.  A two-year clinical and economic follow-up of patients on clozapine. , 1990, Hospital & community psychiatry.

[71]  Frank Lobeck,et al.  The cost-effectiveness of a clinical pharmacy service in an outpatient mental health clinic. , 1989, Hospital & community psychiatry.

[72]  J. Mccombs,et al.  The cost of antidepressant drug therapy failure: a study of antidepressant use patterns in a Medicaid population. , 1990, The Journal of clinical psychiatry.

[73]  T A Sheldon,et al.  Problems of using modelling in the economic evaluation of health care. , 1996, Health economics.

[74]  E. Berndt,et al.  The economic burden of depression in 1990. , 1993, The Journal of clinical psychiatry.

[75]  T. M. Kashner,et al.  Effectiveness of psychiatric intervention with somatization disorder patients: improved outcomes at reduced costs. , 1994, General hospital psychiatry.

[76]  P. Layde,et al.  Congenital hypothyroidism control programs. A cost-benefit analysis. , 1979, JAMA.

[77]  M. Drummond,et al.  Health Care Technology: Effectiveness, Efficiency and Public Policy@@@Methods for the Economic Evaluation of Health Care Programmes , 1988 .

[78]  E Frank,et al.  Cost utility analysis of maintenance treatment for recurrent depression. , 1992, Controlled clinical trials.

[79]  S. Finkler The distinction between cost and charges. , 1982, Annals of internal medicine.

[80]  K. Wells Cost Containment and Mental Health Outcomes: Experiences from US Studies , 1995, British Journal of Psychiatry.

[81]  P. Bebbington,et al.  What Price Depression? , 1994, British Journal of Psychiatry.

[82]  J. Endicott,et al.  Brief versus standard hospitalization: the differential costs. , 1978, The American journal of psychiatry.

[83]  S. Preskorn,et al.  Therapeutic drug monitoring for antidepressants: efficacy, safety, and cost effectiveness. , 1991, The Journal of clinical psychiatry.

[84]  G. Guyatt,et al.  Measuring quality of life in clinical trials: a taxonomy and review. , 1989, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[85]  D. Goldberg,et al.  The Evaluation of a Hostel Ward , 1987, British Journal of Psychiatry.

[86]  P. Potthoff,et al.  Costs and Effects of Managing Chronic Psychotic Patients , 1988, Health Systems Research.

[87]  S. Savitz,et al.  Day hospitalization as a cost-effective alternative to inpatient care: a pilot study. , 1978, Hospital & community psychiatry.

[88]  J. Eisenberg,et al.  Clinical Economics: A Guide to the Economic Analysis of Clinical Practices , 1989 .

[89]  D. Blazer,et al.  The economic burden of depression. , 1986, General hospital psychiatry.

[90]  M. W. Linn,et al.  Nursing home care as an alternative to psychiatric hospitalization. A Veterans Administration cooperative study. , 1985, Archives of general psychiatry.

[91]  M. Hengeveld,et al.  Psychiatric Consultations with Depressed Medical Inpatients: A Randomized Controlled Cost-Effectiveness Study , 1989, International journal of psychiatry in medicine.

[92]  S. Capri,et al.  Cost evaluation of chronic schizophrenic patients during the first 3 years after the first contact. , 1991, Schizophrenia bulletin.

[93]  G. Bond,et al.  Assertive case management in three CMHCs: a controlled study. , 1988, Hospital & community psychiatry.

[94]  Toward the incorporation of costs, cost-effectiveness analysis, and cost-benefit analysis into clinical research. , 1994, Journal of consulting and clinical psychology.

[95]  W. R. Taylor,et al.  Health Care CBA/CEA: An Update on the Growth and Composition of the Literature , 1993, Medical care.

[96]  H. Goldman,et al.  Assessing the costs and outcomes together: Cost effectiveness of two systems of acute psychiatric care☆ , 1990 .

[97]  S. Altshul,et al.  Alternatives to Mental Hospital Treatment , 1979 .

[98]  M. Edlund The economics of anxiety. , 1990, Psychiatric medicine.

[99]  A. Leon,et al.  The Social Costs of Anxiety Disorders , 1995, British Journal of Psychiatry.

[100]  K. Wells,et al.  How can care for depression become more cost-effective? , 1995, JAMA.

[101]  D. Papineau,et al.  A Comparison of the Cost-Effectiveness of Day Treatment and Residential Treatment for Children with Severe Behaviour Problems * , 1992, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[102]  M C Weinstein,et al.  Use and misuse of the term "cost effective" in medicine. , 1986, The New England journal of medicine.

[103]  S. Klagsbrun,et al.  Cost-effective tertiary care. , 1987, The Psychiatric clinics of North America.

[104]  T. Mcguire,et al.  The Quarterway House: a two-year cost study of an experimental residential program. , 1986, Hospital & community psychiatry.

[105]  W. Datel,et al.  A cost-benefit analysis of community versus institutional living. , 1976, Hospital & community psychiatry.

[106]  E. Struening,et al.  A Two-Year Follow-Up of a Comparative Trial of the Cost-Effectiveness of Home and Hospital Psychiatric Treatment * , 1984, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[107]  J. Kleijnen Food supplements and their efficacy , 1991 .

[108]  A. Koch,et al.  The value and cost-effectiveness of a home-visiting programme for psychiatric patients. , 1990, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[109]  H. Häfner,et al.  The Evaluation of Mental Health Care Systems , 1989, British Journal of Psychiatry.

[110]  J. Raftery,et al.  A Controlled Trial of Home-Based Acute Psychiatric Services , 1993, British Journal of Psychiatry.

[111]  R. Deber,et al.  Economic Evaluations in the Canadian Mental Health System I: Theory behind Economic Evaluation* , 1989, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[112]  S. Evers,et al.  Costs of schizophrenia in The Netherlands. , 1995, Schizophrenia bulletin.

[113]  S. Klein,et al.  Cost-benefit analysis of a behavioral program for geriatric inpatients. , 1982, Hospital & community psychiatry.

[114]  D. Kivlahan,et al.  Treatment cost and rehospitalization rate in schizophrenic outpatients with a history of substance abuse. , 1991, Hospital & community psychiatry.

[115]  M. Drummond,et al.  Economic Evaluation of A Support Program for Caregivers of Demented Elderly , 1991, International Journal of Technology Assessment in Health Care.

[116]  W. Heiden,et al.  Effectiveness and cost of community care for schizophrenic patients. , 1989, Hospital & community psychiatry.

[117]  L. Stein,et al.  Alternative to mental hospital treatment. III. Social cost. , 1980, Archives of general psychiatry.

[118]  Y. Sheline,et al.  Cost and utility of routine admission laboratory testing for psychiatric inpatients. , 1990, General hospital psychiatry.

[119]  A. Maynard Cost Management: The Economist's Viewpoint , 1993, British Journal of Psychiatry.

[120]  G. Andrews The cost of schizophrenia revisited. , 1991, Schizophrenia bulletin.

[121]  T. M. Kashner,et al.  A trial of the effect of a standardized psychiatric consultation on health outcomes and costs in somatizing patients. , 1995, Archives of general psychiatry.

[122]  J. Ballenger,et al.  Decentralized services for public hospital patients: a cost analysis. , 1988, Hospital & community psychiatry.

[123]  M. Drummond Survey of cost-effectiveness and cost-benefit analyses in industrialized countries. , 1985, World health statistics quarterly. Rapport trimestriel de statistiques sanitaires mondiales.

[124]  R. Deber,et al.  Economic Evaluations in the Canadian Mental Health System II: From Theory to Practice in Mental Health Care* , 1989, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[125]  B. Weisbrod,et al.  A guide to benefit-cost analysis, as seen through a controlled experiment in treating the mentally ill. , 1983, Journal of health politics, policy and law.

[126]  R. Coursey,et al.  Cost-effectiveness of providing insurance benefits for posthospital psychiatric halfway house stays. , 1990, The American psychologist.

[127]  B. Weisbrod Benefit-cost analysis of a controlled experiment: treating the mentally ill. , 1981, The Journal of human resources.

[128]  D. Wiersma,et al.  Costs and Benefits of Hospital and Day Treatment with Community Care of Affective and Schizophrenic Disorders , 1995, British Journal of Psychiatry.

[129]  R. Rosenheck,et al.  Health care utilization and costs after entry into an outreach program for homeless mentally ill veterans. , 1993, Hospital & community psychiatry.