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Proposal for a new funding system for mental health departments. Results from an evaluative multicentre Italian study (I-psycost)

Published online by Cambridge University Press:  18 May 2011

Laura Grigoletti ,
Francesco Amaddeo ,
Aldrigo Grassi ,
Massimo Boldrini ,
Marco Chiappelli ,
Mauro Percudani ,
Francesco Catapano ,
Andrea Fiorillo ,
Luca Bartoli  and
Maurizio Bacigalupi
...Show all authors
Laura Grigoletti*
Affiliation:
Dipartimento di Medicina e Sanita Pubblica, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
Francesco Amaddeo
Affiliation:
Dipartimento di Medicina e Sanita Pubblica, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
Aldrigo Grassi
Affiliation:
Centro di Salute Mentale “Scalo”, Bologna
Massimo Boldrini
Affiliation:
Centro di Salute Mentale “Scalo”, Bologna
Marco Chiappelli
Affiliation:
Centro di Salute Mentale “Scalo”, Bologna
Mauro Percudani
Affiliation:
Dipartimento di Salute Mentale di Legnano, Milano
Francesco Catapano
Affiliation:
Centro di Salute Mentale “Scalo”, Bologna
Andrea Fiorillo
Affiliation:
Dipartimento di Psichiatria, Seconda Universita di Napoli, Napoli
Luca Bartoli
Affiliation:
Dipartimento di Salute Mentale ASL Roma B, Roma
Maurizio Bacigalupi
Affiliation:
Dipartimento di Salute Mentale ASL Roma B, Roma
Paolo Albanese
Affiliation:
Dipartimento di Salute Mentale ASL Roma B, Roma
Simona Simonetti
Affiliation:
Dipartimento di Scienze Economiche, Università di Verona, Verona
Federico Perali
Affiliation:
Dipartimento di Scienze Economiche, Università di Verona, Verona
Paola De Agostini
Affiliation:
Dipartimento di Scienze Economiche, Università di Verona, Verona
Michele Tansella
Affiliation:
Dipartimento di Medicina e Sanita Pubblica, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
*
Address for correspondence: Dr. L. Grigoletti, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e Psicologia Clinica, Ospedale Policlinico “G.B. Rossi”, P.le L.A. Scuro 10, 37134 Verona Fax: +39-045-8074889 E-mail: laura.grigoletti@medicina.univr.it
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Summary

Aims – To obtain a new, well-balanced mental health funding system, through the creation of i) a list of psychiatric interventions provided by Italian Community-based Psychiatric Services (CPS), and associated costs; ii) a new prospective funding system for patients with a high use of resources, based on packages of care. Methods – Five Italian Community-based Psychiatric Services collected data from 1250 patients during October 2002. Socio-demographical and clinical characteristics and GAF scores were collected at baseline. All psychiatric contacts during the following six months were registered and categorised into 24 service contact types. Using elasticity equation and contact characteristics, we estimate the costs of care. Cluster analysis techniques identified packages of care. Logistic regression defined predictive variables of high use patients. Multinomial Logistic Model assigned each patient to a package of care. Results – The sample's socio-demographic characteristics are similar, but variations exist between the different CPS. Patients were then divided into two groups, and the group with the highest use of resources was divided into three smaller groups, based on number and type of services provided. Conclusions – Our findings show how is possible to develop a cost predictive model to assign patients with a high use of resources to a group that can provide the right level of care. For these patients it might be possible to apply a prospective per-capita funding system based on packages of care.

Declaration of Interest: None

Keywords

mental health servicesfinancial managementeconomic models
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 15 , Issue 4 , December 2006 , pp. 295 - 306
Copyright
Copyright © Cambridge University Press 2006

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