Healthcare costs for young people transitioning the boundary between child/adolescent and adult mental health services in seven European countries : results from the MILESTONE study
BACKGROUND: The boundary between services for children and adolescents and adults has been identified as problematic for young people with mental health problems.
AIMS: To examine the use and cost of healthcare for young people engaged in mental healthcare before and after the child/adolescent and adult service boundary.
METHOD: Data from 772 young people in seven European countries participating in the MILESTONE trial were analysed. We analysed and costed healthcare resources used in the 6-month period before and after the service boundary.
RESULTS: The proportion of young people engaging with healthcare services fell substantially after crossing the service boundary (associated costs €7761 pre-boundary v. €3376 post-boundary). Pre-boundary, the main cost driver was in-patient care (approximately 50%), whereas post-boundary costs were more evenly spread between services; cost reductions were correlated with pre-boundary in-patient care. Severity was associated with substantially higher costs pre- and post-boundary, and those who were engaged specifically with mental health services after the service boundary accrued the greatest healthcare costs post-service boundary.
CONCLUSIONS: Costs of healthcare are large in this population, but fall considerably after transition, particularly for those who were most severely ill. In part, this is likely to reflect improvement in the mental health of young people. However, qualitative evidence from the MILESTONE study suggests that lack of capacity in adult services and young people's disengagement with formal mental health services post-transition are contributing factors. Long-term data are needed to assess the adverse long-term effects on costs and health of this unmet need and disengagement.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
|---|---|
| Enthalten in: |
BJPsych open - 9(2023), 5 vom: 26. Sept., Seite e175 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Canaway, Alastair [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cost of illness |
|---|
| Anmerkungen: |
Date Revised 02.11.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1192/bjo.2023.559 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36246345X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36246345X | ||
| 003 | DE-627 | ||
| 005 | 20231226091310.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1192/bjo.2023.559 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1208.xml |
| 035 | |a (DE-627)NLM36246345X | ||
| 035 | |a (NLM)37749976 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Canaway, Alastair |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Healthcare costs for young people transitioning the boundary between child/adolescent and adult mental health services in seven European countries |b results from the MILESTONE study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 02.11.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a BACKGROUND: The boundary between services for children and adolescents and adults has been identified as problematic for young people with mental health problems | ||
| 520 | |a AIMS: To examine the use and cost of healthcare for young people engaged in mental healthcare before and after the child/adolescent and adult service boundary | ||
| 520 | |a METHOD: Data from 772 young people in seven European countries participating in the MILESTONE trial were analysed. We analysed and costed healthcare resources used in the 6-month period before and after the service boundary | ||
| 520 | |a RESULTS: The proportion of young people engaging with healthcare services fell substantially after crossing the service boundary (associated costs €7761 pre-boundary v. €3376 post-boundary). Pre-boundary, the main cost driver was in-patient care (approximately 50%), whereas post-boundary costs were more evenly spread between services; cost reductions were correlated with pre-boundary in-patient care. Severity was associated with substantially higher costs pre- and post-boundary, and those who were engaged specifically with mental health services after the service boundary accrued the greatest healthcare costs post-service boundary | ||
| 520 | |a CONCLUSIONS: Costs of healthcare are large in this population, but fall considerably after transition, particularly for those who were most severely ill. In part, this is likely to reflect improvement in the mental health of young people. However, qualitative evidence from the MILESTONE study suggests that lack of capacity in adult services and young people's disengagement with formal mental health services post-transition are contributing factors. Long-term data are needed to assess the adverse long-term effects on costs and health of this unmet need and disengagement | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Europe | |
| 650 | 4 | |a Mental health services | |
| 650 | 4 | |a cost of illness | |
| 650 | 4 | |a randomised controlled trial | |
| 650 | 4 | |a transition | |
| 700 | 1 | |a Appleton, Rebecca |e verfasserin |4 aut | |
| 700 | 1 | |a van Bodegom, Larissa |e verfasserin |4 aut | |
| 700 | 1 | |a Dieleman, Gwen |e verfasserin |4 aut | |
| 700 | 1 | |a Franić, Tomislav |e verfasserin |4 aut | |
| 700 | 1 | |a Gerritsen, Suzanne |e verfasserin |4 aut | |
| 700 | 1 | |a de Girolamo, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Maras, Athanasios |e verfasserin |4 aut | |
| 700 | 1 | |a McNicholas, Fiona |e verfasserin |4 aut | |
| 700 | 1 | |a Overbeek, Mathilde |e verfasserin |4 aut | |
| 700 | 1 | |a Paul, Moli |e verfasserin |4 aut | |
| 700 | 1 | |a Purper-Ouakil, Diane |e verfasserin |4 aut | |
| 700 | 1 | |a Santosh, Paramala |e verfasserin |4 aut | |
| 700 | 1 | |a Schulze, Ulrike |e verfasserin |4 aut | |
| 700 | 1 | |a Singh, Swaran P |e verfasserin |4 aut | |
| 700 | 1 | |a Street, Cathy |e verfasserin |4 aut | |
| 700 | 1 | |a Tah, Priya |e verfasserin |4 aut | |
| 700 | 1 | |a Tremmery, Bie |e verfasserin |4 aut | |
| 700 | 1 | |a Tuomainen, Helena |e verfasserin |4 aut | |
| 700 | 1 | |a Verhulst, Frank C |e verfasserin |4 aut | |
| 700 | 1 | |a Wolke, Dieter |e verfasserin |4 aut | |
| 700 | 1 | |a Madan, Jason |e verfasserin |4 aut | |
| 700 | 0 | |a MILESTONE Consortium |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t BJPsych open |d 2015 |g 9(2023), 5 vom: 26. Sept., Seite e175 |w (DE-627)NLM253382912 |x 2056-4724 |7 nnns |
| 773 | 1 | 8 | |g volume:9 |g year:2023 |g number:5 |g day:26 |g month:09 |g pages:e175 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1192/bjo.2023.559 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 9 |j 2023 |e 5 |b 26 |c 09 |h e175 | ||