Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?

International Journal of Environmental Research and Public Health

Minna Sadeniemi¹  Sami Pirkola³  Maiju Pankakoski³  Grigori Joffe²  Raija Kontio⁴  Maili Malin³  Taina Ala-Nikkola³ 

[1] Department of Psychiatry, Hospital District of Helsinki and Uusimaa, Porvoo Health Care Area, Porvoon psykiatrian poliklinikka, Kaivokatu 37, FI-06100 Porvoo, Finland;Department of Psychiatry, University Hospital Region, Hospital District of Helsinki and Uusimaa, Välskärinkatu 12, PL 590, FI-00029 HUS, Finland; E-Mails:;Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 170, FI-00270 Helsinki, Finland; E-Mails:;Department of Psychiatry, Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Vanha Valtatie 198, FI-04500 Kellokoski, Finland; E-Mail:

关键词: costs and cost analysis;    primary health care;    nurses;    psychiatric hospitals;   

DOI  :  10.3390/ijerph110908743

来源: mdpi

【 摘 要 】

Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.