Investigating the relationship between costs and outcomes for English mental health providers: a bi-variate multi-level regression analysis

TitleInvestigating the relationship between costs and outcomes for English mental health providers: a bi-variate multi-level regression analysis
Publication TypeJournal Article
Year of Publication2018
AuthorsMoran V., Jacobs R.
JournalEur J Health Econ
Volume19
Issue5
Pagination709-718
Date PublishedJun
ISBN Number1618-7598
Accession Number28647862
KeywordsAdolescent, Adult, Aged, Aged, 80 and over, Bi-variate model, Costs, England, Female, Humans, Male, mental health, Mental Health Services/*economics, Mental Health/*economics, Middle Aged, Multi-level model, Outcomes, Prospective Studies, Provider performance, Regression Analysis, Young Adult
Abstract

Provider payment systems for mental health care that incentivize cost control and quality improvement have been a policy focus in a number of countries. In England, a new prospective provider payment system is being introduced to mental health that should encourage providers to control costs and improve outcomes. The aim of this research is to investigate the relationship between costs and outcomes to ascertain whether there is a trade-off between controlling costs and improving outcomes. The main data source is the Mental Health Minimum Data Set (MHMDS) for the years 2011/12 and 2012/13. Costs are calculated using NHS reference cost data while outcomes are measured using the Health of the Nation Outcome Scales (HoNOS). We estimate a bivariate multi-level model with costs and outcomes simultaneously. We calculate the correlation and plot the pairwise relationship between residual costs and outcomes at the provider level. After controlling for a range of demographic, need, social, and treatment variables, residual variation in costs and outcomes remains at the provider level. The correlation between residual costs and outcomes is negative, but very small, suggesting that cost-containment efforts by providers should not undermine outcome-improving efforts under the new payment system.

DOI10.1007/s10198-017-0915-5
Reseach Notes

IR-ENL-MASTER

Link

https://www.ncbi.nlm.nih.gov/pubmed/28647862

Short TitleThe European journal of health economics : HEPAC : health economics in prevention and careThe European journal of health economics : HEPAC : health economics in prevention and care
Alternate JournalThe European journal of health economics : HEPAC : health economics in prevention and care