Estimating local need for mental healthcare to inform fair resource allocation in the NHS in England: cross-sectional analysis of national administrative data linked at person level.
AuthorAnselmi, L; Everton, A; Shaw, R; Suzuki, W; Burrows, J; Weir, R; Tatarek-Gintowt, R; Sutton, M; Lorrimer, S
Source TitleBritish Journal of Psychiatry
PublisherCambridge University Press (CUP)
University of Melbourne Author/sSutton, Matthew
AffiliationMelbourne Institute of Applied Economic and Social Research
Document TypeJournal Article
CitationsAnselmi, L., Everton, A., Shaw, R., Suzuki, W., Burrows, J., Weir, R., Tatarek-Gintowt, R., Sutton, M. & Lorrimer, S. (2020). Estimating local need for mental healthcare to inform fair resource allocation in the NHS in England: cross-sectional analysis of national administrative data linked at person level.. British Journal of Psychiatry, 216 (6), pp.338-344. https://doi.org/10.1192/bjp.2019.185.
Access StatusOpen Access
BACKGROUND: Equitable access to mental healthcare is a priority for many countries. The National Health Service in England uses a weighted capitation formula to ensure that the geographical distribution of resources reflects need.AimsTo produce a revised formula for estimating local need for secondary mental health, learning disability (intellectual disability) and psychological therapies services for adults in England. METHOD: We used demographic records for 43 751 535 adults registered with a primary care practitioner in England linked with service use, ethnicity, physical health diagnoses and type of household, from multiple data-sets. Using linear regression, we estimated the individual cost of care in 2015 as a function of individual- and area-level need and supply variables in 2013 and 2014. We sterilised the effects of the supply variables to obtain individual-need estimates. We aggregated these by general practitioner practice, age and gender to derive weights for the national capitation formula. RESULTS: Higher costs were associated with: being 30-50 years old, compared with 20-24; being Irish, Black African, Black Caribbean or of mixed ethnicity, compared with White British; having been admitted for specific physical health conditions, including drug poisoning; living alone, in a care home or in a communal environment; and living in areas with a higher percentage of out-of-work benefit recipients and higher prevalence of severe mental illness. Longer distance from a provider was associated with lower cost. CONCLUSIONS: The resulting needs weights were higher in more deprived areas and informed the distribution of some 12% (£9 bn in 2019/20) of the health budget allocated to local organisations for 2019/20 to 2023/24.Declaration of interestNone.
- Click on "Export Reference in RIS Format" and choose "open with... Endnote".
- Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References