Evening the playing field in public health spending
A new measurement tool will assist balance health spending priorities
People with mental health problems may be disadvantaged when decisions about public health spending are made, according to researchers at the Centre for Health Economics (CHE) at Monash University.
To assist authorities in their decision on the allocation of resources between mental and general health services the CHE developed a questionnaire, the AQoL-8D, which will be used to measure the quality of life of people with mental health problems, before and after they receive health care.
In order to construct the instrument the Monash researchers teamed up with psychiatrists from the University of Melbourne and The Melbourne Clinic. Interviews were conducted with 820 mental health patients in metropolitan hospitals and clinics, together with 500 members of the public.
“The main objective with the Assessment of Mental Health Related Quality of Life (AQol-8D) questionnaire is to assist decision-making about the allocation of recourses between mental and general health services,” Mr Angelo Iezzi, the AQoL project manager in the CHE explained.
“Previous experience has shown that existing generic utility instruments used to examine how people value health related quality of life are not very sensitive when used with people with mental health problems," Mr Iezzi said.
For example, the most widely used instrument has a single question relating to depression and anxiety and nothing about self esteem, relationships, sleep or other psychological dimensions. The new instrument has detailed questions about these, and the usual physical functions which are included in other instruments.
“The results of the study will be used to evaluate the effectiveness of mental health programs and services as well as help inform decisions about health care spending,” Mr Iezzi said.
The importance of the work arises from an increasing recognition of the level of mental ill health in our community, according to the chief investigator, Prof Jeff Richardson, and from the fact that until now economists have been unable to measure the quality of life (QoL) of mental health patients as accurately as the QoL of other patients. The instrument will help create a ‘level playing field’ between patients from different disease groups.
This information will help clinicians and decision-makers to effectively provide mental health programs and services that maximise benefits for the community. This is especially important considering the increasing demand for mental health in Australia, according to Mr Iezzi.
The AQoL group have received an NHMRC grant to test the instrument in the global arena. It will be included in a multi-instrument, multi-disease comparison in six countries. The researchers are optimistic about the capability of their instrument.