THE DYNAMICS OF CHILD MENTAL HEALTH CARE
Author(s)
Dijk HH, Freriks RD, Mierau JO
University of Groningen, Groningen, The Netherlands
OBJECTIVES: We aim to estimate the persistence of mental health care for a population of Dutch children born between 2000 and 2012. The relationship between mental health and care is complex, with multiple mechanisms affecting both individual mental health and the amount of care an individual receives. Therefore, we develop a theoretical model to provide a structural interpretation for the true state-dependence of child mental health care. METHODS: We use administrative data from the Psychiatric Case Registry Northern Netherlands (PCR-NN), which is a longitudinal record of patient contacts with psychiatric institutions between 2000 and 2012. The sample contains 206,283 patient contacts corresponding to 20,193 individuals. We transformed the PCR-NN into a dynamic panel data set, and obtained consistent and unbiased estimates by using difference General Method of Moments (GMM). RESULTS: All estimation results show a positive coefficient smaller than unity, which indicates that the process is stable. An exogenous increase of 10 care moment in the present year is associated with approximately 4 additional care moments in the future. In addition, we find that the role of spurious state-dependence is small. Estimates are robust to numerous sensitivity analyses. CONCLUSIONS: Through the structural interpretation of the model, we can conclude that the persistence of health is likely stronger than the combination of the healing effect of care and the rate at which health problems lead individuals to receive care, but that the process is stable. In other words, if children experience an exogenous adverse mental health event, they will receive an increased number of care moments for a few years, but this effect will weaken over time so that eventually they will receive a base level of care again.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PRM58
Topic
Economic Evaluation, Methodological & Statistical Research
Topic Subcategory
Confounding, Selection Bias Correction, Causal Inference, Cost/Cost of Illness/Resource Use Studies
Disease
Pediatrics