title: [Economic evaluation of the demand of medical care for mental health in Mexico: schizophrenia and depression, 1996-2000].
abstract: Financing protection for both, users and providers of health care services is one of the main objectives of National Program of Health in Mexico, 2001-2006. In fact one of the elements of the present health care reform initiatives is need for the efficient allocation of financial resources, using resource allocation schemes by specific health care demands that combine both the economic, clinical and the epidemiological perspectives. The evaluation of such schemes has been approached in several ways; however, in the case of mental health services, there is dearth of studies that use economic assessment methods. Moreover, such studies are of limited scope, often a response to unmated health needs, disregarding the economic implication for health services production and financing and ensuing medical care market imbalances. This paper presents the results of an evaluative research work aimed to assess the average cost of depression and schizophrenia case management, the financial resources required to meet the health care demands by type of institution, period 1996-2000, in Mexico by type of health care provider. The case management average cost for schizophrenia was $211.00 US, and that for depression was $221.00 US. The demand of services for both conditions in each type of institution showed that the greatest relative demands (96% of the national total for depression and 94% of the national total for schizophrenia) occur in three institutions: IMSS, SSA and ISSSTE. The greatest demand of the health services for the two study condition corresponded to those insured by the IMSS, followed by those uninsured who use the SSA services, and those insured by the ISSSTE. The case management costs for mental conditions are in the middle range between hypertension and diabetes in the upper end, pneumonia and diarrhea in the lower end. The case managment costs of health care demands for the selected tracer conditions differ considerably among institutions for insure populations and those for uninsured populations, with a greater economic impact on-the former. Independent from differences found, these results allow the identification of economic evaluation indicators that could be used to design resource allocation schemes for each of the institutions included in this study.
authors.affiliation: aarredon@insp.mx
authors.forename: Armando
authors.initials: A
authors.lastname: Arredondo
authors.forename: René
authors.initials: R
authors.lastname: Ramos
authors.forename: Alexis
authors.initials: A
authors.lastname: Zúñiga
mesh_terms: D003863:Depression / Q000191:economics / Q000628:therapy*; D005378:Financial Support; D006801:Humans; D008605:Mental Health Services / Q000191:economics* / Q000600:supply & distribution*; D008800:Mexico; D020380:Needs Assessment / Q000191:economics*; D012559:Schizophrenia / Q000191:economics / Q000628:therapy*
vernacular_title: Evaluación económica de la demanda de atención médica para salud mental en México: esquizofrenia y depresión, 1996-2000.