Does primary care mental health resourcing affect the use and costs of secondary psychiatric services?

Int J Environ Res Public Health. 2014 Aug 26;11(9):8743-54. doi: 10.3390/ijerph110908743.

Abstract

Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Finland
  • Health Care Costs
  • Health Resources / economics
  • Health Resources / organization & administration*
  • Health Services Needs and Demand / economics
  • Health Services Needs and Demand / organization & administration
  • Hospitalization
  • Humans
  • Mental Disorders / therapy*
  • Mental Health Services / economics
  • Mental Health Services / organization & administration*
  • Primary Health Care / economics
  • Primary Health Care / organization & administration*
  • Secondary Care Centers* / statistics & numerical data