Healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depression

Abstract Background Effective mental healthcare coverage (EMHC) is an important health system performance indicator of a population’s mental healthcare needs. This study aims to assess the factors and healthcare costs associated with the receipt of EMHC for anxiety and depression. Methods This study...

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Main Authors: Helen-Maria Vasiliadis, Pasquale Roberge, Grace Shen-Tu, Jennifer Vena
Format: Article
Language:English
Published: BMC 2024-12-01
Series:International Journal of Mental Health Systems
Online Access:https://doi.org/10.1186/s13033-024-00653-7
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author Helen-Maria Vasiliadis
Pasquale Roberge
Grace Shen-Tu
Jennifer Vena
author_facet Helen-Maria Vasiliadis
Pasquale Roberge
Grace Shen-Tu
Jennifer Vena
author_sort Helen-Maria Vasiliadis
collection DOAJ
description Abstract Background Effective mental healthcare coverage (EMHC) is an important health system performance indicator of a population’s mental healthcare needs. This study aims to assess the factors and healthcare costs associated with the receipt of EMHC for anxiety and depression. Methods This study draws on data from participants from Alberta’s Tomorrow Project with moderate or severe symptoms of anxiety and depression during the first wave of the COVID-19 pandemic (2020) with available medico-administrative and complete data [n = 720]. EMHC was assessed during the eighteen months as of March 1, 2020, and defined as adequate pharmacotherapy (i.e., antidepressant dispensed, with ≥ 80% proportion of days covered and 4 follow-up medical visits) and/or adequate psychotherapy (≥ 8 physician consultations for psychotherapy) depending on the severity of symptoms. Logistic regression analysis was used to study EMHC as a function of study variables. Regressions with augmented inverse probability weighting were used to estimate the total healthcare costs attributable to receipt of EMHC during the first 18-month period of the pandemic, controlling for confounders. Mean adjusted differences with 95% bias-corrected bootstrap confidence intervals (CIs) are presented. Results The proportion receiving EMHC was 26.7%. Individuals with worse self-rated mental health after the pandemic than before were less likely to receive EMHC. Those with a lifetime diagnosis of depression and anxiety were more likely to receive EMHC. The overall mean adjusted total healthcare costs attributable to receipt of EMHC during the pandemic was $2601 [ – $247, $5694]. The mean adjusted outpatient costs attributable to EMHC was significantly higher and reached $1613 [$873, $2577]. Conclusion The study’s findings highlight the existence of health inequalities and potential unmet mental health needs in individuals with worsening mental health during the pandemic. The receipt of EMHC during the pandemic was not significantly associated with increased total healthcare costs. These findings underscore the need for mental health policies that are aimed at improving timely access to EMHC to address population unmet mental health service needs.
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spelling doaj-art-9cc833db5a2844b7bd6d5249b06a561e2025-08-20T02:57:36ZengBMCInternational Journal of Mental Health Systems1752-44582024-12-0118111010.1186/s13033-024-00653-7Healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depressionHelen-Maria Vasiliadis0Pasquale Roberge1Grace Shen-Tu2Jennifer Vena3Faculty of Medicine and Health Sciences, Université de SherbrookeFaculty of Medicine and Health Sciences, Université de SherbrookeAlberta’s Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services:Alberta’s Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services:Abstract Background Effective mental healthcare coverage (EMHC) is an important health system performance indicator of a population’s mental healthcare needs. This study aims to assess the factors and healthcare costs associated with the receipt of EMHC for anxiety and depression. Methods This study draws on data from participants from Alberta’s Tomorrow Project with moderate or severe symptoms of anxiety and depression during the first wave of the COVID-19 pandemic (2020) with available medico-administrative and complete data [n = 720]. EMHC was assessed during the eighteen months as of March 1, 2020, and defined as adequate pharmacotherapy (i.e., antidepressant dispensed, with ≥ 80% proportion of days covered and 4 follow-up medical visits) and/or adequate psychotherapy (≥ 8 physician consultations for psychotherapy) depending on the severity of symptoms. Logistic regression analysis was used to study EMHC as a function of study variables. Regressions with augmented inverse probability weighting were used to estimate the total healthcare costs attributable to receipt of EMHC during the first 18-month period of the pandemic, controlling for confounders. Mean adjusted differences with 95% bias-corrected bootstrap confidence intervals (CIs) are presented. Results The proportion receiving EMHC was 26.7%. Individuals with worse self-rated mental health after the pandemic than before were less likely to receive EMHC. Those with a lifetime diagnosis of depression and anxiety were more likely to receive EMHC. The overall mean adjusted total healthcare costs attributable to receipt of EMHC during the pandemic was $2601 [ – $247, $5694]. The mean adjusted outpatient costs attributable to EMHC was significantly higher and reached $1613 [$873, $2577]. Conclusion The study’s findings highlight the existence of health inequalities and potential unmet mental health needs in individuals with worsening mental health during the pandemic. The receipt of EMHC during the pandemic was not significantly associated with increased total healthcare costs. These findings underscore the need for mental health policies that are aimed at improving timely access to EMHC to address population unmet mental health service needs.https://doi.org/10.1186/s13033-024-00653-7
spellingShingle Helen-Maria Vasiliadis
Pasquale Roberge
Grace Shen-Tu
Jennifer Vena
Healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depression
International Journal of Mental Health Systems
title Healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depression
title_full Healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depression
title_fullStr Healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depression
title_full_unstemmed Healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depression
title_short Healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depression
title_sort healthcare costs associated with receipt of effective mental healthcare coverage in individuals with moderate or severe symptoms of anxiety and depression
url https://doi.org/10.1186/s13033-024-00653-7
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