School of Applied Economics, and Centre for Strategic Economic Studies, Victoria University, Melbourne, Australia.
Queensland Centre for Mental Health Research, "The Park" - Centre for Mental Health, Australia.
Int J Ment Health Syst. 2008 May 14;2(1):4. doi: 10.1186/1752-4458-2-4.
This article is concerned with the key economic characteristics of Australia's mental health system. First, some brief conceptual and empirical descriptions are provided of Australia's mental health services, both as a total system, and of its two principal components, viz. public psychiatric institutions and private psychiatry services. Expenditures on public psychiatric hospitals clearly demonstrate the effect of deinstitutionalisation. Data from 1984 on private practice psychiatry indicate that per capita utilisation rates peaked in 1996 and have since fallen. Generally, since 1984 gross fees have not risen. However, for both utilisation and fees, there is evidence (of a statistical kind) that there are significant differences between the states of Australia, in these two variables (utilisation and fees). Emphasis is also placed on the economic incentives that arise from health insurance and the heterogeneous nature of mental illness. The effects of these incentives are regarded as by-products of the health insurance mechanism; and another effect, "unmet need" and "met non-need", is a somewhat unique problem of an informational kind. Discussion of many of these issues concludes on a somewhat negative note, e.g. that no empirical results are available to quantify the particular effect that is discussed. This is a manifestation of the lacunae of economic studies of the mental health sector.
这篇文章关注的是澳大利亚精神卫生系统的关键经济特征。首先，对澳大利亚的精神卫生服务，作为一个整体系统，以及其两个主要组成部分，即公立精神病院和私立精神病学服务，提供了一些简要的概念和经验描述。公立精神病院的支出清楚地表明了去机构化的影响。1984 年以来私人开业精神病学的数据表明，人均利用率在 1996 年达到峰值，此后一直在下降。总的来说，自 1984 年以来，总费用并没有上升。然而，对于利用率和费用，有证据（统计上的证据）表明，澳大利亚各州在这两个变量（利用率和费用）上存在显著差异。此外，还强调了医疗保险和精神疾病异质性带来的经济激励。这些激励的影响被视为医疗保险机制的副产品；另一个影响，“未满足的需求”和“满足的非需求”，是一种信息类的独特问题。对许多这些问题的讨论都以一种略显消极的方式结束，例如，没有可用的经验结果来量化所讨论的特定影响。这是精神卫生部门经济研究空白的表现。
