Price indexes are among the most fundamental of economic statistics. They seek to summarize the cost or price of purchasing or producing a particular set of goods and services to attain a certain level of well being. In the health care area price indexes have been conceptualized as the cost of obtaining a certain outcome or quality of care. As such a price index bears directly on how we view the performance of the health economy. The principal goal of this research is to develop price index measures for mental health systems that makes use of administrative data, incorporating learning from clinical research and clinical expertise.
Our aim i s to measure spending (or the price) of treatments associated with an expected level of outcome. The research builds on a series of pilot studies that examined the feasibility of constructing price indexes for the acute phase treatment of major depression. In the research described here, we propose to extend pilot research to: 1) a broader view of treatment for depression (acute plus continuation phase treatment), 2) treatment of schizophrenia and 3) a wider range of settings such as an HMOs with limited mental health benefits and a state Medicaid program. The long term aim of this work is to develop measures that will help policy makers and advocates better interpret data on mental health spending and enhance the ability to assess the performance of programs serving large populations using administrative data and existing clinical research. We will draw upon three large data sets including a large privately insured population from 428,000 enrollees for eight years, 366,000 HMO and POS enrollees for four years to over 3 million Medicaid enrollees over four years. To assess outcomes we will use clinical literature along with three expert panels of clinician-researchers to rate expected outcomes for specific combinations of consumers and treatments.
