Additional file 1 of Using big data and Population Health Management to assess care and costs for patients with severe mental disorders and move toward a value-based payment system

Supplementary Table S1: 2015-2016 SICILIA AND LAZIO ? GLM regressions for all data and selected clusters for costs, SISM costs, AHD costs. Models (M1) Full model on costs, (M2) Full model on SISM costs, (M3) SISM costs no SISM flows (M4) Costs physical health datasets (AHD) (M5) Costs AHD no AHD flows (M6) Costs Cluster 3 (M7) Costs Cluster 4 (M8) Costs Cluster 11 (M9) Costs Cluster 12 (M10) Costs Cluster 13 (M11) Costs Cluster 18 (M12) Costs Cluster 19. Supplementary Figure S1 _ Mean crude and adjusted (for models 1, 2 and 5) costs (reimbursement tariffs) and 95% confidence intervals, pooled Sicily and Lazio, years 2015-2016 - All and Clusters 3, 11, 12, 18, 19

Image_1_From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy.TIF

ObjectivesTo measure the gap between contact and effective coverage of mental healthcare (MHC).Materials and methods45,761 newly referred cases of depression, schizophrenia, bipolar disorder, and personality disorder from four Italian regions were included. A variant of the self-controlled case series method was adopted to estimate the incidence rate ratio (IRR) for the relationship between exposure (i.e., use of different types of MHC such as pharmacotherapy, generic contact with the outpatient services, psychosocial intervention, and psychotherapy) and relapse (emergency hospital admissions for mental illness).Results11,500 relapses occurred. Relapse risk was reduced during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI: 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99), and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for patients with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic care, in absence of psychosocial/psychotherapeutic interventions, did not affect risk of relapse.ConclusionThis study ascertained the gap between contact and effective coverage of MHC and showed that administrative data can usefully contribute to assess the effectiveness of a mental health system.</p

Data_Sheet_1_From contact coverage to effective coverage of community care for patients with severe mental disorders: A real-world investigation from Italy.docx

ObjectivesTo measure the gap between contact and effective coverage of mental healthcare (MHC).Materials and methods45,761 newly referred cases of depression, schizophrenia, bipolar disorder, and personality disorder from four Italian regions were included. A variant of the self-controlled case series method was adopted to estimate the incidence rate ratio (IRR) for the relationship between exposure (i.e., use of different types of MHC such as pharmacotherapy, generic contact with the outpatient services, psychosocial intervention, and psychotherapy) and relapse (emergency hospital admissions for mental illness).Results11,500 relapses occurred. Relapse risk was reduced during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI: 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99), and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for patients with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic care, in absence of psychosocial/psychotherapeutic interventions, did not affect risk of relapse.ConclusionThis study ascertained the gap between contact and effective coverage of MHC and showed that administrative data can usefully contribute to assess the effectiveness of a mental health system.</p