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Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- And middle-income countries- And PRIME cohort study: the PRIME cohort study

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Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- And middle-income countries- And PRIME cohort study : the PRIME cohort study. / Chisholm, Dan; Garman, Emily; Breuer, Erica et al.

In: Health Policy and Planning, Vol. 35, No. 5, 01.06.2020, p. 567-576.

Research output: Contribution to journalArticlepeer-review

Harvard

Chisholm, D, Garman, E, Breuer, E, Fekadu, A, Hanlon, C, Jordans, M, Kathree, T, Kigozi, F, Luitel, N, Medhin, G, Murhar, V, Petersen, I, Rathod, SD, Shidhaye, R, Ssebunnya, J, Patel, V & Lund, C 2020, 'Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- And middle-income countries- And PRIME cohort study: the PRIME cohort study', Health Policy and Planning, vol. 35, no. 5, pp. 567-576. https://doi.org/10.1093/heapol/czz182

APA

Chisholm, D., Garman, E., Breuer, E., Fekadu, A., Hanlon, C., Jordans, M., Kathree, T., Kigozi, F., Luitel, N., Medhin, G., Murhar, V., Petersen, I., Rathod, S. D., Shidhaye, R., Ssebunnya, J., Patel, V., & Lund, C. (2020). Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- And middle-income countries- And PRIME cohort study: the PRIME cohort study. Health Policy and Planning, 35(5), 567-576. https://doi.org/10.1093/heapol/czz182

Vancouver

Chisholm D, Garman E, Breuer E, Fekadu A, Hanlon C, Jordans M et al. Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- And middle-income countries- And PRIME cohort study: the PRIME cohort study. Health Policy and Planning. 2020 Jun 1;35(5):567-576. https://doi.org/10.1093/heapol/czz182

Author

Chisholm, Dan ; Garman, Emily ; Breuer, Erica et al. / Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- And middle-income countries- And PRIME cohort study : the PRIME cohort study. In: Health Policy and Planning. 2020 ; Vol. 35, No. 5. pp. 567-576.

Bibtex Download

@article{a4fa34857a5a47ceb8db291c4e4c8a94,
title = "Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- And middle-income countries- And PRIME cohort study: the PRIME cohort study",
abstract = "This study examines the level and distribution of service costs-and their association with functional impairment at baseline and over time-for persons with mental disorder receiving integrated primary mental health care. The study was conducted over a 12-month follow-up period in five low- and middle-income countries participating in the Programme for Improving Mental health carE study (Ethiopia, India, Nepal, South Africa and Uganda). Data were drawn from a multi-country intervention cohort study, made up of adults identified by primary care providers as having alcohol use disorders, depression, psychosis and, in the three low-income countries, epilepsy. Health service, travel and time costs, including any out-of-pocket (OOP) expenditures by households, were calculated (in US dollars for the year 2015) and assessed at baseline as well as prospectively using linear regression for their association with functional impairment. Cohort samples were characterized by low levels of educational attainment (Ethiopia and Uganda) and/or high levels of unemployment (Nepal, South Africa and Uganda). Total health service costs per case for the 3 months preceding baseline assessment averaged more than US$20 in South Africa, $10 in Nepal and US$3-7 in Ethiopia, India and Uganda; OOP expenditures ranged from $2 per case in India to $16 in Ethiopia. Higher service costs and OOP expenditure were found to be associated with greater functional impairment in all five sites, but differences only reached statistical significance in Ethiopia and India for service costs and India and Uganda for OOP expenditure. At the 12-month assessment, following initiation of treatment, service costs and OOP expenditure were found to be lower in Ethiopia, South Africa and Uganda, but higher in India and Nepal. There was a pattern of greater reduction in service costs and OOP spending for those whose functional status had improved in all five sites, but this was only statistically significant in Nepal.",
keywords = "Mental health care, low- and middle-income countries, service costs",
author = "Dan Chisholm and Emily Garman and Erica Breuer and Abebaw Fekadu and Charlotte Hanlon and Mark Jordans and Tasneem Kathree and Fred Kigozi and Nagendra Luitel and Girmay Medhin and Vaibhav Murhar and Inge Petersen and Rathod, {Sujit D} and Rahul Shidhaye and Joshua Ssebunnya and Vikram Patel and Crick Lund",
note = "{\textcopyright} World Health Organization 2020. All rights reserved. The World Health Organization has granted the Publisher permission for the reproduction of this article.",
year = "2020",
month = jun,
day = "1",
doi = "10.1093/heapol/czz182",
language = "English",
volume = "35",
pages = "567--576",
journal = "Health Policy and Planning",
issn = "0268-1080",
publisher = "Oxford University Press",
number = "5",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Health service costs and their association with functional impairment among adults receiving integrated mental health care in five low- And middle-income countries- And PRIME cohort study

T2 - the PRIME cohort study

AU - Chisholm, Dan

AU - Garman, Emily

AU - Breuer, Erica

AU - Fekadu, Abebaw

AU - Hanlon, Charlotte

AU - Jordans, Mark

AU - Kathree, Tasneem

AU - Kigozi, Fred

AU - Luitel, Nagendra

AU - Medhin, Girmay

AU - Murhar, Vaibhav

AU - Petersen, Inge

AU - Rathod, Sujit D

AU - Shidhaye, Rahul

AU - Ssebunnya, Joshua

AU - Patel, Vikram

AU - Lund, Crick

N1 - © World Health Organization 2020. All rights reserved. The World Health Organization has granted the Publisher permission for the reproduction of this article.

PY - 2020/6/1

Y1 - 2020/6/1

N2 - This study examines the level and distribution of service costs-and their association with functional impairment at baseline and over time-for persons with mental disorder receiving integrated primary mental health care. The study was conducted over a 12-month follow-up period in five low- and middle-income countries participating in the Programme for Improving Mental health carE study (Ethiopia, India, Nepal, South Africa and Uganda). Data were drawn from a multi-country intervention cohort study, made up of adults identified by primary care providers as having alcohol use disorders, depression, psychosis and, in the three low-income countries, epilepsy. Health service, travel and time costs, including any out-of-pocket (OOP) expenditures by households, were calculated (in US dollars for the year 2015) and assessed at baseline as well as prospectively using linear regression for their association with functional impairment. Cohort samples were characterized by low levels of educational attainment (Ethiopia and Uganda) and/or high levels of unemployment (Nepal, South Africa and Uganda). Total health service costs per case for the 3 months preceding baseline assessment averaged more than US$20 in South Africa, $10 in Nepal and US$3-7 in Ethiopia, India and Uganda; OOP expenditures ranged from $2 per case in India to $16 in Ethiopia. Higher service costs and OOP expenditure were found to be associated with greater functional impairment in all five sites, but differences only reached statistical significance in Ethiopia and India for service costs and India and Uganda for OOP expenditure. At the 12-month assessment, following initiation of treatment, service costs and OOP expenditure were found to be lower in Ethiopia, South Africa and Uganda, but higher in India and Nepal. There was a pattern of greater reduction in service costs and OOP spending for those whose functional status had improved in all five sites, but this was only statistically significant in Nepal.

AB - This study examines the level and distribution of service costs-and their association with functional impairment at baseline and over time-for persons with mental disorder receiving integrated primary mental health care. The study was conducted over a 12-month follow-up period in five low- and middle-income countries participating in the Programme for Improving Mental health carE study (Ethiopia, India, Nepal, South Africa and Uganda). Data were drawn from a multi-country intervention cohort study, made up of adults identified by primary care providers as having alcohol use disorders, depression, psychosis and, in the three low-income countries, epilepsy. Health service, travel and time costs, including any out-of-pocket (OOP) expenditures by households, were calculated (in US dollars for the year 2015) and assessed at baseline as well as prospectively using linear regression for their association with functional impairment. Cohort samples were characterized by low levels of educational attainment (Ethiopia and Uganda) and/or high levels of unemployment (Nepal, South Africa and Uganda). Total health service costs per case for the 3 months preceding baseline assessment averaged more than US$20 in South Africa, $10 in Nepal and US$3-7 in Ethiopia, India and Uganda; OOP expenditures ranged from $2 per case in India to $16 in Ethiopia. Higher service costs and OOP expenditure were found to be associated with greater functional impairment in all five sites, but differences only reached statistical significance in Ethiopia and India for service costs and India and Uganda for OOP expenditure. At the 12-month assessment, following initiation of treatment, service costs and OOP expenditure were found to be lower in Ethiopia, South Africa and Uganda, but higher in India and Nepal. There was a pattern of greater reduction in service costs and OOP spending for those whose functional status had improved in all five sites, but this was only statistically significant in Nepal.

KW - Mental health care

KW - low- and middle-income countries

KW - service costs

UR - http://www.scopus.com/inward/record.url?scp=85084718533&partnerID=8YFLogxK

U2 - 10.1093/heapol/czz182

DO - 10.1093/heapol/czz182

M3 - Article

C2 - 32150273

VL - 35

SP - 567

EP - 576

JO - Health Policy and Planning

JF - Health Policy and Planning

SN - 0268-1080

IS - 5

ER -

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