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The development of a Local Index of Need (LIN) and its use to explain variations in social services expenditure on mental health care in England
- Authors:
- McCRONE Paul, et al
- Journal article citation:
- Health and Social Care in the Community, 14(3), May 2006, pp.242-253.
- Publisher:
- Wiley
This paper's aims are to (1) describe the development of a new indicator of mental health needs, (2) use the index to explain variations in social services expenditure on mental health, and (3) compare the index with other established measures of need. A principal components analysis of sociodemographic variables considered to be indicators of need was used to produce four distinct factors for 148 Local Authority areas in England. A weighted sum of these factors was used to produce a single index. (Weights were the proportion of variance explained by each factor.) The index was used in a regression model to explain variations in spending on mental health care and was compared with (1) a model containing the four individual factors, (2) the current method of allocating resources, (3) the index used to allocate resources to primary care trusts, (4) the Mental Illness Needs Index (MINI), (5) four indices of deprivation produced by the Office of the Deputy Prime Minister, and (6) the average of the above four indices. The new index could explain 54% of variation, compared with 56% using the current method. The four-factor model could explain 66%, whilst the other models could explain between 37% and 20%. This new index has the advantage that it is not based on previous levels of utilisation or expenditure and yet still explains a comparable amount of variation as the current method. However, a disaggregated model containing individual factors may be preferable.
Economic evaluation of early intervention (EI) services: phase IV report
- Authors:
- McCRONE Paul, PARK A-La, KNAPP Martin
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2010
- Pagination:
- 22p., bibliog.
- Place of publication:
- Canterbury
Using a 2006 model adapted during 3 previous research phases, Phase IV focuses on the economic impacts of early intervention services (EI) on vocational and employment outcomes of people with mental health problems, including psychoses, in the UK. The report also covers long-term outcomes of EI and the impact on costs associated with suicide and murder. Four findings are discussed. Firstly, EI reduced NHS health care, and wages costs of employment lost to mental health problems, with employment rates of 36% and 27% attributed to those in EI and standard care (SC), respectively. Costs of homicide are low, say these authors, with annual costs per person at £6 for those in EI compared with £80 for SC. Thirdly, suicide is estimated to occur in 1.3% EI and 4% SC patients, equating to annual savings of £957 per person. Finally, long-term outcomes associated with EI are dependent on readmission rates following EI discharge. They equate to costs savings of £36,632 over 8 years if rates remain constant. If rates gradually or immediately converge expected savings dip to £27,029 and £17,427, respectively. The increased work and decreased homicides and suicides recorded here reinforce earlier work that EI is beneficial to the UK’s mental health.