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Predicting costs of mental health care: a critical literature review

机译：预测精神卫生保健的费用：一篇重要的文献综述

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Background. Cost evaluation research in the mental health field is being increasingly recognized as a way to achieve a more effective deployment of scarce resources. However, there is a paucity of studies that seek to identify predictors of psychiatric service utilization and costs. This paper aims to critically review the published research in the field of psychiatric service utilization and costs, and discusses current methodological developments in this field. Method. Sixteen studies were identified and are critically reviewed. Results. No single variable alone can explain variations in costs between patients; instead, a range of different clinical and non-clinical variables provides a greater explanation of cost variations. Having a history of previous psychiatric service use is the most consistent predictor of higher psychiatric costs. Only one study considers indirect costs incurred by users, their families and friends and society as a whole, with the remaining 15 studies focusing on direct mental health care costs. There is a lack of studies that consider the future psychiatric service utilization and costs of care of children and older people. The cross-validation of predictive models is not yet routine, with only four of the studies including a cross-validation procedure. Conclusions. The predictive approach in mental health cost evaluation has relevance for both mental health policy and practice. However, there is a paucity of studies that focus on children, older people and indirect costs. Furthermore, there remain a number of methodological challenges to address.
机译：背景。精神卫生领域的成本评估研究越来越被认为是实现稀缺资源更有效配置的一种方式。但是，很少有研究试图确定精神科服务利用和成本的预测因素。本文旨在批判性地回顾在精神科服务利用和成本领域中已发表的研究，并讨论该领域当前的方法学发展。方法。确定了十六项研究，并对其进行了严格审查。结果。没有任何一个单独的变量可以解释患者之间费用的差异。取而代之的是，一系列不同的临床和非临床变量为费用变动提供了更好的解释。具有以前使用过精神病服务的历史是对较高精神病费用的最一致的预测指标。只有一项研究考虑了用户，他们的家人，朋友和整个社会的间接费用，其余15项研究关注的是直接精神保健费用。缺乏研究来考虑未来的精神科服务利用以及儿童和老年人的护理费用。预测模型的交叉验证还不是常规方法，只有四项研究包括交叉验证程序。结论。精神卫生费用评估中的预测方法与精神卫生政策和实践都息息相关。但是，很少有研究集中在儿童，老年人和间接费用上。此外，仍然存在许多方法上的挑战要解决。

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