Variation in spend on young mental health across Clinical Commissioning Groups in England: a cross-sectional observational study.
Adolescent
Adolescent Health
Adolescent Health Services
/ economics
Child
Child Health
Child Health Services
/ economics
Costs and Cost Analysis
/ methods
England
/ epidemiology
Female
Health Care Rationing
/ standards
Health Services Needs and Demand
/ economics
Humans
Male
Mental Health Services
/ economics
State Medicine
/ economics
child and adolescent psychiatry
health economics
mental health
organisation of health services
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
07 10 2019
07 10 2019
Historique:
entrez:
10
10
2019
pubmed:
9
10
2019
medline:
24
10
2020
Statut:
epublish
Résumé
To investigate whether the rate of spend on child and adolescent mental health is influenced by demand for other competing services in local commissioning decisions. Analysis of spend data by Clinical Commissioning Groups (CCG), including other publicly available data to control for variation in need. Local commissioning decisions in the National Health Service. Commissioning of health services across 209 CCGs. Association between the rate of child and adolescent mental health spend and demand for child and adolescent mental health services (CAMHS), adult mental health services and physical health services after adjusting for confounding factors. An additional percentage point in the proportion of children in care is associated with 4% higher child and young person mental health (CYP MH) spend per person aged 0-18 (ratio of means: 1.04; 95% CI 1.00 to 1.07). Spending £100 more on physical health services was associated with 9% lower spend in CYP MH per person aged 0-18 (ratio of means: 0.91; 95% CI 0.84 to 0.99). Healthcare commissioners in England face a challenge in balancing competing needs. This paper contributes to our understanding of this by quantifying the possible extent of the trade-off between physical health and CYP MH when allocating budgets. Any attempt to explain the variation in CAMHS spend must also take account of demand for other services.
Identifiants
pubmed: 31594880
pii: bmjopen-2019-030011
doi: 10.1136/bmjopen-2019-030011
pmc: PMC6797274
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e030011Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
BMJ. 1993 Jul 31;307(6899):309-11
pubmed: 8374382
BMJ Open. 2016 Nov 16;6(11):e012337
pubmed: 27852712
Heart. 2015 Aug;101(15):1182-9
pubmed: 26041770
Soc Sci Med. 2017 Dec;195:42-49
pubmed: 29132081
Lancet. 2016 Jun 11;387(10036):2423-78
pubmed: 27174304
Eur J Health Econ. 2018 Apr;19(3):309-313
pubmed: 29086086
Lancet. 2012 Jun 23;379(9834):2373-82
pubmed: 22726518
Aust Health Rev. 2019 Feb;43(1):43-48
pubmed: 29129189
BMJ. 2017 Jan 26;356:j451
pubmed: 28126737
Curr Opin Psychiatry. 2007 Jul;20(4):359-64
pubmed: 17551351
Yale J Biol Med. 2013 Jun 13;86(2):271-80
pubmed: 23766747
J Med Ethics. 2008 Jul;34(7):540-4
pubmed: 18591290
Yale J Biol Med. 2011 Dec;84(4):471-8
pubmed: 22180684
Arch Dis Child. 2019 Jul;104(7):618-621
pubmed: 29720493
J Child Psychol Psychiatry. 2005 Sep;46(9):919-30
pubmed: 16108995
Lancet Psychiatry. 2017 Feb;4(2):120-127
pubmed: 28087201
BMJ. 2012 Nov 01;345:e7127
pubmed: 23118304