PubMed · 15346798
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J Michael Pontious. 2004. Healing or curing.. https://pubmed.ncbi.nlm.nih.gov/15346798/
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BACKGROUND: There is no doubt that mental health care should be geared toward evidence, cost-effectiveness, and need. Health care data that allow comparisons of demand and real needs are scarce. This is especially true for outpatient care. METHOD: The aim of this study was to assess and analyze data from health insurance plans and social welfare. RESULTS: The costs of mental health care in Germany amount to 13 mio per year and 100,000 population. Health insurance schemes account for two thirds of total costs and social welfare for one third. The distribution of expenses seems not to be based on need analyses. Especially the chronically mentally ill are disadvantaged. CONCLUSIONS: The redistribution of expenses from inpatient to outpatient care including integrated health care approaches would result in more cost-effective mental health care.
The East Asian economies of Indonesia, Malaysia and Thailand suffered declines in their economic growth rates in 1997. The Indonesian and Thai government followed the World Bank prescription for adjustment, which included a cut-back in government spending at a time when there were significant job losses. Malaysia chose its own path to adjustment. Evidence presented in this paper shows that although the declines were short-lived that there was an impact on the health status measured by mortality rates for the populations of Indonesia and Thailand. There was little apparent impact on the health status of Malaysians. The lessons for other developing economies include the importance of social safety nets and the maintenance of government expenditure in minimising the impact of economic shocks on health.
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