title: [Proposal for a new funding system for mental health departments. Results from an evaluative multicentre Italian study (I-psycost)].
abstract: OBJECTIVE
  To obtain a new, well-balanced mental health funding system, through the creation of (i) a list of psychiatric interventions provided by Italian Community-based Psychiatric Services (CPS), and associated costs; (ii) a new prospective funding system for patients with a high use of resources, based on packages of care.
  
  
  METHODS
  Five Italian Community-based Psychiatric Services collected data from 1250 patients during October 2002. Socio-demographical and clinical characteristics and GAF scores were collected at baseline. All psychiatric contacts during the following six months were registered and categorised into 24 service contact types. Using elasticity equation and contact characteristics, we estimate the costs of care. Cluster analysis techniques identified packages of care. Logistic regression defined predictive variables of high use patients. Multinomial Logistic Model assigned each patient to a package of care.
  
  
  RESULTS
  The sample's socio-demographic characteristics are similar, but variations exist between the different CPS. Patients were then divided into two groups, and the group with the highest use of resources was divided into three smaller groups, based on number and type of services provided.
  
  
  CONCLUSIONS
  Our findings show how is possible to develop a cost predictive model to assign patients with a high use of resources to a group that can provide the right level of care. For these patients it might be possible to apply a prospective per-capita funding system based on packages of care.
authors.affiliation: Dipartimento di Medicina e Sanità Publica, Sezione di Psichiatria e Psicologia Clinica, Universiti di Verona, Verona, Italy. laura.grigoletti@medicina.univr.it
authors.forename: Laura
authors.initials: L
authors.lastname: Grigoletti
authors.forename: Francesco
authors.initials: F
authors.lastname: Amaddeo
authors.forename: Aldrigo
authors.initials: A
authors.lastname: Grassi
authors.forename: Massimo
authors.initials: M
authors.lastname: Boldrini
authors.forename: Marco
authors.initials: M
authors.lastname: Chiappelli
authors.forename: Mauro
authors.initials: M
authors.lastname: Percudani
authors.forename: Francesco
authors.initials: F
authors.lastname: Catapano
authors.forename: Andrea
authors.initials: A
authors.lastname: Fiorillo
authors.forename: Luca
authors.initials: L
authors.lastname: Bartoli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bacigalupi
authors.forename: Paolo
authors.initials: P
authors.lastname: Albanese
authors.forename: Simona
authors.initials: S
authors.lastname: Simonetti
authors.forename: Federico
authors.initials: F
authors.lastname: Perali
authors.forename: Paola
authors.initials: P
authors.lastname: De Agostini
authors.forename: Michele
authors.initials: M
authors.lastname: Tansella
mesh_terms: D002202:Capital Financing; D003164:Competitive Bidding; D006801:Humans; D007558:Italy / Q000453:epidemiology; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D008605:Mental Health Services / Q000191:economics*