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- Andrén, Daniela, Associate Professor, 1968-
(författare)
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Prioritizing Suicide Prevention through the Lens of the Individual's Well-Being
- 2023
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Ingår i: Journal of Mental Health Policy and Economics. - : John Wiley & Sons. - 1091-4358 .- 1099-176X. ; 26:Suppl. 1, s. S4-S4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: The need for priority setting in healthcare became evident during the Covid-19 pandemic, when planned care was postponed facilitating emergency treatment of Covid-19 patients, raisinquestions about the population’s preferences.Aim: To estimate the population values interventions reducing the number of suicides in comparison to treatments reducing the number of deaths due to other causes in a country where healthcare system has a pronounced public character and a declared emphasis on equity and solidarity during a time when the limited healthcare resources were predominantly allocated for the treatment of Covid patients.Data and Methods: The data was collected via a web survey sent to members of the web panel Userneeds during a tree-week period starting with the last week of December 2021, when media was informing the population about global experts and politicians’ huge concern about the extremely high infection risk of the Omicron. The survey was designed to identify the populations’ preferences for the allocation of the limited health care resources to save lives. An online discrete choice experiment was conducted among a sample of 1000 respondents to elicit the relative importance placed on reducing the number of deaths due to suicide in comparison to deaths due to pancreatic cancer, breast cancer and acute heart attack. The sample is representative with respect age, gender, and geographical region for the adult population of Sweden.Results: Respondents with high value of life satisfaction and no experience of any of the four health conditions chose to allocate a given limited healthcare budget for relatively young people but not to suicide. When not controlling for the individual’s life satisfaction, the respondents seem to prioritize the interventions that reduce the risk of young people to die due to suicide and breast cancer.Discussion: Even though the derived value of suicide prevention is near the average willingness to pay for suicide prevention, in general, a value derived using Wellbeing Valuation should not be seen as the actual amount that people would be willing to pay.
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- Andrén, Daniela, Associate Professor, 1968-
(författare)
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Valuing Mental Illness by Using the Well-Being Valuation Method
- 2022
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Ingår i: Journal of Mental Health Policy and Economics. - : John Wiley & Sons. - 1091-4358 .- 1099-176X. ; 25:Suppl. 1, s. S2-S2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Each year, near one million individuals worldwide commit suicide, and several more make suicide attempts. Both suicide and suicide attempts are a source of tremendous grief among friends and relatives of the victim, which generate large costs for society. This has prompted calls for more research on interventions that prevent suicide and self-harm behaviors, their costs and the society willingness to pay (WTP) for such interventions. Suicide screening followed by an intervention may identify suicidal individuals and prevent recurring self-harm, but few cost-effectiveness studies have been conducted.Aims of the Study: We aim to derive the value of suicide prevention by using the wellbeing valuation method.Methods: We use data collected from a representative sample of 1038 Swedish residents aged 18-80, who were randomly selected from a web-panel. They answered questions about the importance of interventions aimed prevent suicide and their WTP for these interventions. They also reported their life-satisfaction, their direct and indirect experience with mental disorders, including knowing someone who committed suicide or suicide attempt, variable needed to apply the well-being approach. In a first step, we estimate life satisfaction equations, controlling additionally to the well-known determinants such as satisfaction with health, income, and martial satisfaction, for variables related to suicide (e.g., the individual’s awareness about suicide because a close friend or relative committed suicide or had a suicide attempt and the individual’s s willingness to pay for suicide prevention). In the second step, we derive the value of suicide prevention by using the estimates of awareness about suicide and income from the life satisfaction equations.Results: Our preliminary estimates show that knowing someone who committed suicide or suicide attempt has positive significant effect on the individual’s life satisfaction, and the preliminary derived value of suicide prevention is near the average willingness to pay for suicide prevention.Discussion: Even though the derived value of suicide prevention is near the average willingness to pay for suicide prevention, in general, a value derived using Wellbeing Valuation should not be seen as the actual amount that people would be willing to pay.
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- Beckman, Linda, 1980-, et al.
(författare)
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Economic Costs of Antidepressant Use: A Population-Based Study in Sweden
- 2019
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Ingår i: Journal of Mental Health Policy and Economics. - Italy. - 1091-4358 .- 1099-176X. ; 22:4, s. 125-130
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prescription of antidepressant drugs (ADs) has increased in recent decades, with rising costs for patients as well as for the health care system. There is sparse evidence of which factors explain the high economic costs and financial burden for the general population. Aims of the study: The aim was to assess individual-level determinants of out-of-pocket and total health care costs of AD use in the Swedish general population. Methods: We randomly sampled 400,000 individuals aged 18+ from Statistics Sweden's population register from 2010 to 2013. Two-part regression models were used for our two primary outcome variables: (i) total health care costs for AD use per year and individual, and (ii) total out-of-pocket costs of AD use per year and individual. Results: Women, the unemployed, unmarried people and residents of big cities have both higher use of ADs and higher associated total health care and out-of-pocket costs. Today, ADs are relatively inexpensive and average cost differences among all groups are therefore minor. The elderly have higher use of ADs, but are more commonly low-volume users and do not have higher total health care or out-of-pocket costs. Discussion and limitations: Groups with relatively low socioeconomic status are at risk of higher costs for antidepressant use. However, given the Swedish system of drug subsidies, differences in financial burden for individuals are minor. The limitations of this study included that we lacked data on diagnosis and could therefore not categorize the reasons for AD consumption. Furthermore, our results may not be generalized to other countries with a lower AD prevalence then Sweden's, since our estimates are dependent on the point prevalence of antidepressant use in the population. Implications for health care provision and use: Groups with higher AD consumption and economic costs may suffer from more severe depression owing to more risk factors and less social support in their surroundings, and may be in greater need of additional treatment and support than other groups. Implications for health policies and further research: Our results offer insight at an aggregate level, and more information on the underlying causes of higher costs is needed to discern the policy implications.
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- Ekman, M., et al.
(författare)
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The Societal Cost of Schizophrenia in Sweden
- 2013
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Ingår i: Journal of Mental Health Policy and Economics. - 1091-4358. ; 16:1, s. 13-25
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Tidskriftsartikel (refereegranskat)abstract
- Background: Schizophrenia is a disabling psychiatric disorder that has severe consequences for patients and their families. Moreover, the expensive treatment of schizophrenia imposes a burden on health care providers and the wider society. Existing cost estimates for Sweden, however, are based on relatively small patient populations and need to be confirmed in a large register-based study. Aims of the Study: To investigate the health care resource utilization and cost-of-illness in patients with schizophrenia in Sweden and to relate the costs to hospitalizations and global assessment of functioning (GAF). Methods: Hospital-based registry data were combined with national registry data from a large patient population to get reliable estimates of the costs of schizophrenia in Sweden. Schizophrenia was defined by ICD-10 codes F20; F21; F23.1,2,8,9; F25.1,8,9. Registry data on socio-demographics and disease-related healthcare resource use in outpatient and inpatient care were obtained from Northern Stockholm Psychiatry. Data on pharmaceuticals were obtained from the National Board of Health and Welfare, and data on sick leave and early retirement were obtained from the Swedish Social Insurance Agency. Costs for community mental health care were not available at the individual level, but were estimated based on previous studies and aggregate cost data from Stockholm. Resource use data from the registries were combined with unit costs from publicly available sources. The study was conducted from a societal perspective, with indirect costs valued according to the human capital method. Results: The average annual psychiatric cost per patient with schizophrenia in 2008 was 42 700 (95% CI: 41 500 44 000), based on a sample of 2 161 patients. To this should be added costs for community mental health care of 12 400 per patient, giving a total cost of 55 100 per patient. The two largest cost items in the total costs were indirect costs due to lost productivity (60%) and community mental health care (22% of the total cost). Patients who were hospitalized in 2008 had greater psychiatric costs than those who were not, (sic)71 700 vs. (sic)37 700 (p<0.0001). Psychiatric costs were significantly and negatively correlated with GAF (p<0.001). Discussion: The major strengths of the study are the relatively large sample, and the linkage of patient-level clinical data on inpatient and outpatient care with national registry data on prescription pharmaceuticals, and days on social insurance. A limitation was that costs for informal care and primary care were not included in the data, but previous studies suggest that these costs items are small compared to other costs for schizophrenia. Implications for Health Policies and Future Research: Costs were strongly related to hospitalization and GAF, suggesting that attempts to improve global functioning and avoid hospitalizations by means of effective treatment and rehabilitation might not only decrease suffering for patients and relatives, but also reduce the societal cost of schizophrenia. A detailed knowledge of the societal costs can also be helpful in evaluating the cost-effectiveness of new treatment strategies to improve the care for patients with schizophrenia.
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- Hjortsberg, Catharina, et al.
(författare)
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Costs for patients with psychotic illness : differences depending upon state of remission
- 2011
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Ingår i: The Journal of Mental Health Policy and Economics. - Milano. - 1091-4358. ; 14:2, s. 87-93
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Tidskriftsartikel (refereegranskat)abstract
- Psychotic illnesses have a substantial economic burden on patients, family members, friends, and society in general, still there have been limited attempts to estimate the costs associated with this condition. Moreover, nothing is known about the differences in costs between patients depending on disease severity, i.e. state of remission.AIM:Estimate the direct and indirect costs for a defined patient population with psychotic illness in Sweden, and demonstrate differences in direct costs depending on disease severity (state of remission).MATERIALS AND METHODS:The cost analyses are based on data from the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), which is an ongoing, single-centre, epidemiological study. Resource use and disease severity were captured for the patients during one year, 2007. Total costs per patients are estimated and cost differences between patients, depending on state of remission, are considered.RESULTS:199 patients with a mean age of 51 (63% men) were followed for 12 months. They had a mean of 6.4 inpatient-days, 1.4 physician visits, 18.6 nurse visits, 1.2 counsellor visits and 6.3 visits to other staff including tests and diagnostic procedures per patient- year. The mean total cost (direct and indirect) amounted to 62,500 per patient and year. Patients in steady state of remission had lower direct costs compared to other patients. Moreover, the size of the various cost items differed between patients' depending on state of remission. Patients in steady remission had almost no inpatient costs.DISCUSSION:For a comprehensive assessment of treatment of psychotic illnesses it is necessary to provide evidence of the costs related to disease severity. We find that patients suffering from psychotic illness have varying costs depending on their disease severity, and this study indicates that if patients can be kept in remission direct costs will decrease. We can also confirm that reallocation has taken place the last 15 years, between different cost items, from in-patient care at hospitals to out-patient care and assistance at home.LIMITATIONS:Information about informal care was collected from patients and not from informal carers themselves.IMPLICATIONS FOR HEALTH CARE PROVISION AND USE:Costs have been reallocated from in-patient care to costs for assistance at home, which is a reflection of the change in care of patients with mental problems that has taken place during the last 15 years. Patients in steady remission have lower costs compared to patients in steady non-remission or patients switching between the two states. A better surveillance of the disorder would lead to lower direct, as well as indirect, costs.
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