scholarly journals Public Health System-Delivered Mental Health Preventive Care Links to Significant Reduction of Health Care Costs

2018 ◽  
Vol 21 (6) ◽  
pp. 462-468 ◽  
Author(s):  
Jie Chen ◽  
Priscilla Novak ◽  
Howard Goldman
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Care ◽  
Health System ◽  
Health Care Costs ◽  
Preventive Care ◽  
Public Health System ◽  
Care Costs

scholarly journals Identifying superusers of health services with mental health and addiction problems

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Jacqueline Quail ◽  
Maureen Anderson ◽  
Meric Osman ◽  
Claire De Oliveira ◽  
Walter Wodchis ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Early Childhood ◽  
Health Services ◽  
Health Care Costs ◽  
Hypodermic Needle ◽  
Notifiable Disease ◽  
Care Costs

ABSTRACT ObjectiveThe objective of this research is to identify people with mental health and/or addiction (MHA) problems and determine characteristics that led to them becoming a superuser of health services (i.e., the most expensive 10% of all health service users). ApproachIn Saskatchewan, Canada, we used hospital and physician administrative data spanning 2005 to 2014 to identify the MHA cohort. We will calculate total health care costs for each individual and assign them to one of three groups: low cost users (<50th percentile), moderate cost users (50-<90th percentile), and superusers (90th percentile and above). For each group, we will describe sociodemographic characteristics, disease characteristics, and use of health services, and describe their trajectory towards becoming a superuser. Predictors of becoming a superuser will be identified. A novel aspect of this research is the inclusion of sociobehavioural risk factors by linking 4 population and public health administrative datasets obtained from the Saskatoon Health Region to the provincial administrative health services data. Sociobehavioral factors are widely accepted as strongly influencing health. Each database was selected because it captures data on a sociobehavioral factor. The Oral Health Database contains data on early childhood development, including early childhood tooth decay, dental health status, and tobacco use in elementary school-aged children. The Integrated Public Health Information System contains data on self-reported ethnicity, the occurrence of an infectious notifiable disease, and behavioural and social risk factors for the notifiable disease. The Sexually Transmitted Infection (STI) Clinic Data contains data on exposure to and contraction of STIs, as well as referrals given for mental health and/or addiction services. Finally, the Street Outreach Program provides services to individuals living a high-risk lifestyle on the street. Their database contains information on self-reported ethnicity, hypodermic needle exchange, and homelessness. ResultsIn a province of approximately 1.1 million people, we identified 417,724 people as having at least 1 MHA diagnosis, of which two-thirds were depression and/or anxiety. Substance abuse was found in 9.4%, and schizotypal and psychotic disorders were found in 7.9%, of the MHA cohort, ConclusionIndividuals with severe MHA problems account for a disproportionate amount of health care costs. Identifying predictors of becoming an MHA superuser may afford an opportunity to intervene, possibly years in the future, to prevent a person from becoming a superuser. If true, this has significant implications for health care costs, wait times to access health services, and quality of life for this vulnerable population.

scholarly journals Comparative analysis between prevention and treatment costs for gestational diabetes mellitus in primary and tertiary health care in a city in Southern Brazil

2021 ◽  
Vol 13 (1) ◽  
pp. 21-30
Author(s):  
Ricardo Reichenbach ◽  
◽  
Yasmin Reis ◽  
Maria Carolina Gullo ◽  
José Mauro Madi ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health System ◽  
Public Health System ◽  
Economic Valuation ◽  
Southern Brazil ◽  
Economic Context

Objective: The present study’s purpose is to evaluate the economic context in which the Brazilian public health system, the only universal public health system with more than 200 million users, stands out. This evaluation will be made through the lens of the execution of gestational health care services in a city of approximately 500 thousand inhabitants in southern Brazil. The care costs of patients with gestational diabetes mellitus (GDM) will be compared to those of patients without GDM, analyzing the different economic valuation methods. And lastly, there was an intent to explore the generated costs in the context of economic valuation applied to health to comprehend better the complexity of the union of the financial and health areas to optimize the services offered. Methods: For the economic context in health, an analysis of health investments was performed through the Transparency Portal. The costs involved in preventing GDM were raised by the Sistema Único de Saúde (SUS) table of procedures performed ordinarily in low-risk pregnancies. The expenses involved in DMG patients were increased at the High-Risk Pregnancy and Fetal Medicine Clinic of DMG patients. Results: Preventing GDM is more cost-effective, cost-minimizing, and cost-useful than treating patients diagnosed with GDM. Conclusion: The result is an extremely interesting costopportunity, given the economic context in which it is presented

scholarly journals Delays and Unmet Need for Health Care Among Adult Primary Care Patients in a Restructured Urban Public Health System

2004 ◽  
Vol 94 (5) ◽  
pp. 783-789 ◽  
Author(s):  
Allison L. Diamant ◽  
Ron D. Hays ◽  
Leo S. Morales ◽  
Wesley Ford ◽  
Daphne Calmes ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Unmet Need ◽  
Primary Care Patients

scholarly journals The preventive health care act and the future forum public health in Germany

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
F De Bock ◽  
Y Shajanian Zarneh ◽  
S Matusall
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Health System ◽  
Public Health System ◽  
National Level ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Life Course Perspective ◽  
Bottom Up

Abstract The public health system in Germany, similar to education and cultural affairs, is characterised by the federal structure. It is mainly regulated and decided at the state and municipal level, and not primarily at the national level. The preventive health care act (The Act to Strengthen Health Promotion and Preventive Health Care) (2015) underlines the setting-based approach of health promotion and takes a life course perspective by recommending goals of growing up healthy, living and working healthy and healthy ageing. The act formulates broad recommendations for prevention and health promotion at the national level, that in turn take on concrete forms in mandatory framework agreements at the federal state level with uniform health objectives. On the whole, the key objective of the act is to improve preventive health care and general health promotion. Also the financing of the act by the mandatory health insurance is a special feature and at the same time a novelty. At the same time a bottom-up project has been recently launched with the aim to develop a public health strategy in Germany. The project future forum public health (ZfPH) is a platform for public health professionals, researchers and students following incorporated concepts of policy analysis as well as methods that will ensure participation, transparency and transferability of the results into policy and practice. Over the next three years, ZfPH’s steering group will moderate a participatory process, including stakeholders from public health practice and research as well as policy makers. In an evidence-based approach, they will first analyse the current state of Germany’s public health system before developing concrete policy recommendations for a coherent and efficient public health system. The presentation will give a short overview over the German public health system and the preventive health care act, its structure and the achievements as well as the bottom-up project future forum public health.

PP155 The Impact Of Lawsuits In The Brazilian Public Health System

2017 ◽  
Vol 33 (S1) ◽  
pp. 141-141
Author(s):  
Carla Biella ◽  
Viviane Pereira ◽  
Fabiana Raynal ◽  
Jorge Barreto ◽  
Vania Canuto ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Scientific Evidence ◽  
Health Technology ◽  
Health Technologies ◽  
Access To Health ◽  
The Right ◽  
The Impact

INTRODUCTION:The increase of litigation in Brazil on the right to health, and the Brazilian Public Health System (SUS) targets of litigation, are phenomena that generate discussions both in the judiciary, and among researchers and managers of health. The lawsuits are based on the integrality that includes the right to any health technology. Our aim was to gather information on the use of scientific evidence by judges and other law professionals to support their decisions in lawsuits involving health care in Brazil.METHODS:A narrative review by literature search using key terms of legalization in specific databases was conducted.RESULTS:Twenty-five studies showed litigation matters relating to health care which were focused on legal claims about drugs. In general, law operators used the scientific evidences in a limited way when making decisions, by considering the medical report and medication label indications and disregarding therapeutic alternatives contemplated in the SUS list. The access to health technologies, by litigation, reveals that the gap between scientific knowledge and legal practice are similar to those found between science and decision-making in the formulation and implementation of health policies. The Health Technology Assessment studies have high potential for use by the judiciary as a reference source to support technical and scientific decisions in lawsuits on health care.CONCLUSIONS:For the judiciary to ensure not only access to health technologies, but also the efficacy and safety of technologies to system users, their decisions must be substantiated by scientific evidence. The National Committee for Health Technology Incorporation (CONITEC) in SUS has established actions in conjunction with law operators and society, such as a communication using e-mail, aiding the decision for the injunction and elaboration of technical reports and a policy brief, with the intention that the decisions are taken with the greatest possible knowledge about technologies provided by SUS, and based on scientific evidence.

scholarly journals Development of a gender-relevant tobacco cessation intervention for women in Brazil—an intervention mapping approach to planning

2019 ◽  
Vol 34 (5) ◽  
pp. 505-520
Author(s):  
N�dia Kienen ◽  
Tha�s Dist�fano Wiltenburg ◽  
Lorna Bittencourt ◽  
Isabel C Scarinci
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Tobacco Cessation ◽  
Public Health System ◽  
Intervention Mapping ◽  
The Public ◽  
Cessation Intervention ◽  
Care System

Abstract The purpose of this article is to describe the development of a theory-based, culturally and gender-relevant Community Health Worker (CWH)-led tobacco cessation intervention for low-income Brazilian women who augments the tobacco cessation program offered through the public health system using Intervention Mapping (IM). We began with the establishment of a network of representatives from different segments of society followed by comprehensive needs assessments. We then established a logical planning process that was guided by a theoretical framework (Social Cognitive Theory) and existing evidence-based tobacco cessation programs, taking into account socio-political context of a universal health care system. Given the gender-relevance of our intervention and the importance of social support in tobacco cessation among women, we chose an intervention that would be delivered within the public health system but augmented by CHWs that would be trained in behavior change by researchers. One of major advantages of utilizing IM was that decisions were made in a transparent and supportive manner with involvement of all stakeholders throughout the process. Despite the fact that this process is very taxing on researchers and the health care system as it takes time, resources and negotiation skills, it builds trust and promotes ownership which can assure sustainability.

scholarly journals Direct Health Care Costs of Treating Seasonal Affective Disorder: A Comparison of Light Therapy and Fluoxetine

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Amy Cheung ◽  
Carolyn Dewa ◽  
Erin E. Michalak ◽  
Gina Browne ◽  
Anthony Levitt ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Affective Disorder ◽  
Health Care Costs ◽  
Seasonal Affective Disorder ◽  
Light Therapy ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Care Costs

Objective.To compare the direct mental health care costs between individuals with Seasonal Affective Disorder randomized to either fluoxetine or light therapy.Methods.Data from the CANSAD study was used. CANSAD was an 8-week multicentre double-blind study that randomized participants to receive either light therapy plus placebo capsules or placebo light therapy plus fluoxetine. Participants were aged 18–65 who met criteria for major depressive episodes with a seasonal (winter) pattern. Mental health care service use was collected for each subject for 4 weeks prior to the start of treatment and for 4 weeks prior to the end of treatment. All direct mental health care services costs were analysed, including inpatient and outpatient services, investigations, and medications.Results.The difference in mental health costs was significantly higher after treatment for the light therapy group compared to the medication group—a difference of $111.25 (z=−3.77,P=0.000). However, when the amortized cost of the light box was taken into the account, the groups were switched with the fluoxetine group incurring greater direct care costs—a difference of $75.41 (z=−2.635,P=0.008).Conclusion.The results suggest that individuals treated with medication had significantly less mental health care cost after-treatment compared to those treated with light therapy.

Criminal Justice and Behavioral Health Care Costs of Mental Health Court Participants: A Six-Year Study

2014 ◽  
Vol 65 (9) ◽  
pp. 1100-1104 ◽  
Author(s):  
Henry J. Steadman ◽  
Lisa Callahan ◽  
Pamela Clark Robbins ◽  
Roumen Vesselinov ◽  
Thomas G. McGuire ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Criminal Justice ◽  
Behavioral Health ◽  
Health Care Costs ◽  
Behavioral Health Care ◽  
Mental Health Court ◽  
Care Costs
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