Mental health inpatient care: how should services be organised in a NHS?

Detalhes bibliográficos
Autor(a) principal: Matias, Maria Ana Bártolo Coelho Ramalho
Data de Publicação: 2016
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/18610
Resumo: Research masters
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spelling Mental health inpatient care: how should services be organised in a NHS?Mental healthInpatient careEconomies of scaleIntegrated continuous careServices organisationDomínio/Área Científica::Ciências Sociais::Economia e GestãoResearch mastersOrganisation of mental health care provided by hospitals can be done with concentration of services in a few units or with several hospitals providing them. The trade-o↵ to be made is between being closer to patients having several units of low volume activity each or benefiting from economies of scale to obtain better outcomes. We address here the magnitude of the scale e↵ects in mental health care. This provides important information to address the above-mentioned trade-o↵. We also analyse the importance of integrated continuous care services in mental health as a complement to inpatient care by computing the potential savings to the National Health Service (NHS). These services are a set of sequential interventions in mental health and/or social support, focusing on rehabilitation and recovery of patients with psychosocial disability. Analysing both economies of scale and integrated continuous care are relevant issues for mental health system financing. We use a diagnosis related group (DRG) dataset from 2001 to 2013 considering only mental health inpatient discharges, from an European country with a case-mix based funding system (Portugal). Using a conditional risk set model, we find a scale e↵ect for each DRG that ranges between 0 and 1 day. The magnitude of the scale e↵ect is not sufficiently high to justify the centralisation of psychiatric services in higher volume hospitals. We find potential savings for the NHS if integrated continuous care was in place. The focus of mental health system redesign should be on promoting integrated mental health care, with concentration of hospital services not being particularly relevant.Barros, Pedro PitaRUNMatias, Maria Ana Bártolo Coelho Ramalho2016-08-04T09:05:15Z2016-062016-062016-06-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10362/18610TID:201481863enginfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T03:57:58Zoai:run.unl.pt:10362/18610Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:24:52.517991Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Mental health inpatient care: how should services be organised in a NHS?
title Mental health inpatient care: how should services be organised in a NHS?
spellingShingle Mental health inpatient care: how should services be organised in a NHS?
Matias, Maria Ana Bártolo Coelho Ramalho
Mental health
Inpatient care
Economies of scale
Integrated continuous care
Services organisation
Domínio/Área Científica::Ciências Sociais::Economia e Gestão
title_short Mental health inpatient care: how should services be organised in a NHS?
title_full Mental health inpatient care: how should services be organised in a NHS?
title_fullStr Mental health inpatient care: how should services be organised in a NHS?
title_full_unstemmed Mental health inpatient care: how should services be organised in a NHS?
title_sort Mental health inpatient care: how should services be organised in a NHS?
author Matias, Maria Ana Bártolo Coelho Ramalho
author_facet Matias, Maria Ana Bártolo Coelho Ramalho
author_role author
dc.contributor.none.fl_str_mv Barros, Pedro Pita
RUN
dc.contributor.author.fl_str_mv Matias, Maria Ana Bártolo Coelho Ramalho
dc.subject.por.fl_str_mv Mental health
Inpatient care
Economies of scale
Integrated continuous care
Services organisation
Domínio/Área Científica::Ciências Sociais::Economia e Gestão
topic Mental health
Inpatient care
Economies of scale
Integrated continuous care
Services organisation
Domínio/Área Científica::Ciências Sociais::Economia e Gestão
description Research masters
publishDate 2016
dc.date.none.fl_str_mv 2016-08-04T09:05:15Z
2016-06
2016-06
2016-06-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/18610
TID:201481863
url http://hdl.handle.net/10362/18610
identifier_str_mv TID:201481863
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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