Financing for better mental health care
The 'Financing systems' effects on the quality of mental health care in Europe' (REFINEMENT) project has produced the first-ever comparative and comprehensive overview of links between mental health care financing and outcomes of mental health services in Europe. An experienced team of mental health service researchers, public health specialists and health economists conducted the study across nine European countries. As such, it covered a representative range of health care systems in terms of funding models, and interfaces with social care services. Project partners examined how variations in the structure and characteristics of mental health financing systems impact quality of care and the appropriateness of pathways through the services system. Activities included analyses of the financing of health and social care systems, and of functional and dysfunctional financial incentives. The team mapped services for mental health care, and studied quality of mental health care and met and unmet needs. Action was also taken to build best practice models of mental health care financing. To meet objectives set out in these areas of focus, REFINEMENT developed tools to map and describe certain specifics of mental health care financing systems. Examples of some of these are REMAST, for individuals with mental disorders, and Fincento A, for collecting information on the financing of health and social care systems as well as the use of innovative financing tools across participant countries. Papers on relevant systematic review methodology and findings were produced for journal submission, and a report was issued detailing data collected with REMAST. The latter constitutes an atlas of health and social services in the nine partner countries, namely Austria, Estonia, Finland, France, Italy, Norway, Romania, Spain and the United Kingdom. Outcomes have helped identify best practices and effective financing system innovations and components. They also helped to draw conclusions and present recommendations on the best way to structure funding systems in different country contexts. Furthermore, the findings help European policymakers and care providers better understand complexities involved in financing mental health care systems as well as primary and social care services. As such, the project set a basis for considering the use of alternative health care financing models in different contextual settings.
Keywords
Mental health, health care, performance assessment, financing systems, mental health services, health economists, social care services, mental health financing, health care financing