Healthcare costs for young people transitioning the boundary between child/adolescent and adult mental health services in seven European countries: Results from the MILESTONE study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue BJPsych Open Année : 2023

Healthcare costs for young people transitioning the boundary between child/adolescent and adult mental health services in seven European countries: Results from the MILESTONE study

Alastair G. Canaway
  • Fonction : Auteur
Rebecca Appleton
  • Fonction : Auteur
Larissa S. van Bodegom
Gwen C. Dieleman
Tomislav Franic
Suzanne E. Gerritsen
  • Fonction : Auteur
Giovanni de Girolamo
Athanasios Maras
  • Fonction : Auteur
Fiona Mcnicholas
  • Fonction : Auteur
Mathilde M. Overbeek
  • Fonction : Auteur
Moli Paul
  • Fonction : Auteur
Paramala Janardhanan Santosh
Ulrike M.E. Schulze
  • Fonction : Auteur
Swaran Preet Singh
  • Fonction : Auteur
Cathy Street
  • Fonction : Auteur
Priya Tah
  • Fonction : Auteur
Bie Tremmery
  • Fonction : Auteur
Helena Tuomainen
Frank C. Verhulst
  • Fonction : Auteur
Dieter Wolke
Jason J. Madan

Résumé

Background The boundary between services for children and adolescents and adults has been identified as problematic for young people with mental health problems. Aims To examine the use and cost of healthcare for young people engaged in mental healthcare before and after the child/adolescent and adult service boundary. Method Data from 772 young people in seven European countries participating in the MILESTONE trial were analysed. We analysed and costed healthcare resources used in the 6-month period before and after the service boundary. Results The proportion of young people engaging with healthcare services fell substantially after crossing the service boundary (associated costs €7761 pre-boundary v. €3376 post-boundary). Pre-boundary, the main cost driver was in-patient care (approximately 50%), whereas post-boundary costs were more evenly spread between services; cost reductions were correlated with pre-boundary in-patient care. Severity was associated with substantially higher costs pre- and post-boundary, and those who were engaged specifically with mental health services after the service boundary accrued the greatest healthcare costs post-service boundary. Conclusions Costs of healthcare are large in this population, but fall considerably after transition, particularly for those who were most severely ill. In part, this is likely to reflect improvement in the mental health of young people. However, qualitative evidence from the MILESTONE study suggests that lack of capacity in adult services and young people's disengagement with formal mental health services post-transition are contributing factors. Long-term data are needed to assess the adverse long-term effects on costs and health of this unmet need and disengagement. Copyright
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hal-04334551 , version 1 (14-12-2023)

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Alastair G. Canaway, Rebecca Appleton, Larissa S. van Bodegom, Gwen C. Dieleman, Tomislav Franic, et al.. Healthcare costs for young people transitioning the boundary between child/adolescent and adult mental health services in seven European countries: Results from the MILESTONE study. BJPsych Open, 2023, 9 (5), ⟨10.1192/bjo.2023.559⟩. ⟨hal-04334551⟩
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