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Using health production functions to evaluate treatment effectiveness: an application to a community mental health service

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  • Andrew Healey
  • Massimo Mirandola
  • Francesco Amaddeo
  • Paola Bonizzato
  • Michele Tansella

Abstract

The randomized controlled trial (RCT) is the recommended means of evaluating health care effectiveness and cost‐effectiveness. Whilst representing a ‘gold‐standard’ in health services research, RCT evidence on the clinical and economic desirability of services and treatments is often absent. Where RCT evidence is lacking, or where it is infeasible to implement randomized controlled comparisons, longitudinal observational and naturalistic data sources when analysed appropriately can yield useful insights regarding the clinical effectiveness and economic efficiency of treatments. In this paper we demonstrate the utility of applying panel estimation methods to data from an Italian psychiatric case register as a means of modelling the mental health outcomes of patients referred to a community‐based mental health service. Emphasis is placed on quantifying the clinical effectiveness of consultations with different mental health professionals (including in‐patient days) and whether service outcomes are affected by psychiatric diagnosis. The impact of service consultations and their interaction with different types of psychiatric diagnosis on a measure of patient mental health are found to be statistically significant, although the size of these effects are not substantial from a clinical perspective. Copyright © 2000 John Wiley & Sons, Ltd.

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  • Andrew Healey & Massimo Mirandola & Francesco Amaddeo & Paola Bonizzato & Michele Tansella, 2000. "Using health production functions to evaluate treatment effectiveness: an application to a community mental health service," Health Economics, John Wiley & Sons, Ltd., vol. 9(5), pages 373-383, July.
  • Handle: RePEc:wly:hlthec:v:9:y:2000:i:5:p:373-383
    DOI: 10.1002/1099-1050(200007)9:5<373::AID-HEC522>3.0.CO;2-6
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    References listed on IDEAS

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    2. McClellan, Mark & Newhouse, Joseph P., 1997. "The marginal cost-effectiveness of medical technology: A panel instrumental-variables approach," Journal of Econometrics, Elsevier, vol. 77(1), pages 39-64, March.
    3. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    4. Cebu Study Team, 1992. "A child health production function estimated from longitudinal data," Journal of Development Economics, Elsevier, vol. 38(2), pages 323-351, April.
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    1. Halsteinli, Vidar & Karterud, Sigmund & Pedersen, Geir, 2008. "When costs count: The impact of staff size, skill mix and treatment intensity on patient outcome for psychotherapeutic day treatment programmes," Health Policy, Elsevier, vol. 86(2-3), pages 255-265, May.
    2. Negri­n, Miguel A. & Vázquez-Polo, Francisco-José, 2008. "Incorporating model uncertainty in cost-effectiveness analysis: A Bayesian model averaging approach," Journal of Health Economics, Elsevier, vol. 27(5), pages 1250-1259, September.
    3. F. J. Vázquez‐Polo & M. A. Negrín Hernández & B. González López‐Valcárcel, 2005. "Using covariates to reduce uncertainty in the economic evaluation of clinical trial data," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 545-557, June.
    4. Halsteinli, Vidar & Kittelsen, Sverre A. & Magnussen, Jon, 2010. "Productivity growth in outpatient child and adolescent mental health services: The impact of case-mix adjustment," Social Science & Medicine, Elsevier, vol. 70(3), pages 439-446, February.
    5. Matosevic, Tihana & Knapp, Martin & Forder, Julien & Kendall, Jeremy, 2000. "Independent sector domiciliary care providers in 1999," LSE Research Online Documents on Economics 19012, London School of Economics and Political Science, LSE Library.
    6. Francisco-José Polo & Miguel Negrín & Xavier Badía & Montse Roset, 2005. "Bayesian regression models for cost-effectiveness analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 45-52, March.
    7. Miguel A. Negrín & Francisco J. Vázquez-Polo & María Martel & Elías Moreno & Francisco J. Girón, 2010. "Bayesian Variable Selection in Cost-Effectiveness Analysis," IJERPH, MDPI, vol. 7(4), pages 1-20, April.

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