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加拿大综合青年服务的实施:泛加拿大模式的规划与成本核算:加拿大青年综合服务的实施:泛加拿大模式的规划与成本核算。

The Implementation of Integrated Youth Services in Canada: Planning and Costing of a Pan-Canadian Model: La mise en œuvre des services intégrés pour les jeunes au Canada : planification et établissement des coûts d'un modèle pancanadien.

作者信息

Henderson Jo L, de Oliveira Claire, Mathias Steve

机构信息

Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

Can J Psychiatry. 2024 Dec 10:7067437241301008. doi: 10.1177/07067437241301008.

Abstract

OBJECTIVE

The implementation of Integrated Youth Services (IYS) can help ensure that youth are adequately supported. The objective of this analysis was to provide a model for the planning and costing of IYS throughout Canada over a 15-year period.

METHODS

To estimate resource allocation for IYS, we determined the number of hubs and hub staffing requirements by service level and jurisdiction, backbone support and infrastructure requirements by jurisdiction. A needs-based analytic framework for planning was employed to estimate the number of hubs required. The optimal mix of hub staffing requirements was determined based on prior literature. The costs of running each hub were estimated using publicly available data and internal documents from existing IYS agencies. Finally, the cost of setting up IYS hubs, IYS virtual care and respective backbone support throughout Canada was estimated and projected over 15 years and the cost-savings of IYS were calculated.

RESULTS

At maturity, it was estimated that 399 hubs-188 small, 43 medium, 168 large-across Canada would be required to address youth mental health and substance use needs. The cost of implementing IYS initiatives across Canada would vary between $4,349,126 (for less populous jurisdictions) and $248,950,524 (for more populous jurisdictions), for a total annual cost of $676,633,388 (excluding costs of infrastructure). It was estimated that the implementation of IYS hubs would lead to cost-savings of $2.1 billion annually and have the potential to be cost-effective.

CONCLUSION

The implementation of IYS hubs can provide good value for money, in the form of high client satisfaction, earlier supports with improved youth outcomes and decreased health care costs. Future work should address gaps in data availability on mental health and substance use-related needs of youth with neurodevelopmental disorders, youth experiencing homelessness, youth in congregate living and foster care, and Indigenous youth.

摘要

目的

实施综合青年服务(IYS)有助于确保青年获得充分支持。本分析的目的是提供一个在15年期间为加拿大全国IYS进行规划和成本核算的模型。

方法

为了估计IYS的资源分配,我们根据服务水平和司法管辖区确定了中心的数量以及中心人员配备要求,根据司法管辖区确定了骨干支持和基础设施要求。采用基于需求的规划分析框架来估计所需中心的数量。根据先前的文献确定中心人员配备要求的最佳组合。使用公开数据和现有IYS机构的内部文件估计每个中心的运营成本。最后,估计并预测在15年期间在加拿大各地建立IYS中心、IYS虚拟护理及相应骨干支持的成本,并计算IYS的成本节约情况。

结果

在成熟阶段,估计加拿大全国需要399个中心——188个小型、43个中型、168个大型——以满足青年心理健康和物质使用需求。在加拿大各地实施IYS倡议的成本在4349126加元(人口较少的司法管辖区)至248950524加元(人口较多的司法管辖区)之间,每年总成本为676633388加元(不包括基础设施成本)。据估计,实施IYS中心每年将节省21亿加元成本,并且有可能具有成本效益。

结论

实施IYS中心可以提供高性价比,表现为高客户满意度、更早的支持、改善青年成果以及降低医疗成本。未来的工作应解决在患有神经发育障碍的青年、无家可归青年、集体生活和寄养青年以及原住民青年的心理健康和物质使用相关需求的数据可用性方面的差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d7/12163289/5387aa425308/10.1177_07067437241301008-fig1.jpg

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