This Research Scientist Development Award application addresses a fundamental question for policy makers -- namely, how to sub-divide the resources allocated to health care. The research focuses on the financing of mental health services. The methodology involves comparing different mental health delivery systems -- including those of the United States and Canada. There is a large body of research showing that mental health problems are common, potentially disabling, yet often quite treatable. Recent studies have indicated that many mental disorders have a biological component. There is growing impetus to further the integration of mental health within the larger health care system. The question naturally arises as to how much of the health care dollar should be allocated for mental health. This question is complicated by the different populations of individuals who use mental health services as well as by the diverse settings in which these services are delivered. Methodology is needed to compare mental health financing, services, and outcomes among different types of health care systems. There is considerable interest in comparing Canadian and American systems for financing mental health services. Detailed accounting methods will be used to compare the portion of the health care dollar assigned to mental health in Oregon with the analogous figure in British Columbia. Methods for calculating those figures will be documented. The techniques necessary to replicate this work in other states and provinces will be disseminated. The award will also lead to the development and refinement of methodology for linking the financial data with outcome measures. Conceptual work will be performed to elaborate a model that relates resource expenditures to mental health outcomes. The model will then be applied to local and national data sets. The anticipated product is a better understanding of the changes in individual and system level outcome measures that might be expected under various health care reform scenarios. The results will include a picture of the changes that might be expected in the mental health area if the United States (or a single state) were to adopt a Canadian style single payer system.
| McFarland, Bentson H; Khorramzadeh, Suzann; Millius, Rebecca et al. (2002) Psychiatric hospital length of stay for Medicaid clients before and after managed care. Adm Policy Ment Health 29:191-9 |
| Goetz, R R; McFarland, B H; Ross, K V (2000) Effects of runaway health care costs. New Dir Ment Health Serv :3-Jan |
| Zani, B; McFarland, B; Wachal, M et al. (1999) Statewide replication of predictive validation for the Multnomah Community Ability Scale. Community Ment Health J 35:223-9 |
| Cutler, D L; McFarland, B H; Winthrop, K (1998) Mental health in the Oregon Health Plan: fragmentation or integration? Adm Policy Ment Health 25:361-86 |
| McFarland, B H; George, R A; Goldman, W et al. (1998) Population-based guidelines for performance measurement: a preliminary report. Harv Rev Psychiatry 6:23-37 |
| McFarland, B H; Winthrop, K; Cutler, D L (1997) Integrating mental health into the Oregon Health Plan. Psychiatr Serv 48:191-3 |
| McFarland, B H (1997) Automated pharmacy databases and behavioral health care quality assurance. Eval Rev 21:371-8 |
| McFarland, B H; Johnson, R E; Hornbrook, M C (1996) Enrollment duration, service use, and costs of care for severely mentally ill members of a health maintenance organization. Arch Gen Psychiatry 53:938-44 |
| Backlar, P; McFarland, B H (1996) A survey on use of advance directives for mental health treatment in Oregon. Psychiatr Serv 47:1387-9 |
