TY - JOUR
T1 - Impact of the workforce allocation on the technical performance of mental health services
T2 - the collective case of Helsinki-Uusimaa (Finland)
AU - Diaz-Milanes, Diego
AU - Almeda, Nerea
AU - Gutierrez-Colosia, Mencia R.
AU - Garcia-Alonso, Carlos R.
AU - Sadeniemi, Minna
AU - Salvador-Carulla, Luis
N1 - Funding Information:
We would like to thank the National Institute for Health and Welfare of Helsinki, Helsinki City and Hospital District of Helsinki and Uusimaa. Special thanks to Kristian Wahlbeck, Niklas Grönlund, Irja Hemmilä, Grigori Joffe, Jutta Järvelin, Raija Kontio, Maili Malin, Petri Näätänen, Sami Pirkola, Eila Sailas, Marjut Vastamäki and all other members of the REFINEMENT Group.
Funding Information:
Financial support for this study was provided in part by a grant from the Carlos III Health Institute (PI18/01521) and the Regional Government of Andalusia (PY18-RE-0022), with European Union FEDER teams. The original database on service provision and social determinants of health in the Helsinki-Uusimaa region was part of the Refinement Project funded by the European Commission Seventh Framework Programme (FP7/2007–2013 and FP7/2007–2011) under grant agreement no. 261459. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, and writing and publishing the report.
Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.
PY - 2023/10/23
Y1 - 2023/10/23
N2 - Background: Long-term mental health (MH) policies in Finland aimed at investing in community care and promoting reforms have led to a reduction in the number of psychiatric hospital beds. However, most resources are still allocated to hospital and community residential services due to various social, economic and political factors. Despite previous research focussing on the number and cost of these services, no study has evaluated the emerging patterns of use, their technical performance and the relationship with the workforce structure. Objective: The purpose of this study was to observe the patterns of use and their technical performance (efficiency) of the main types of care of MH services in the Helsinki-Uusimaa region (Finland), and to analyse the potential relationship between technical performance and the corresponding workforce structure. Methods: The sample included acute hospital residential care, non-hospital residential care and outpatient care services. The analysis was conducted using regression analysis, Monte Carlo simulation, fuzzy inference and data envelopment analysis. Results: The analysis showed a statistically significant linear relationship between the number of service users and the length of stay, number of beds in non-hospital residential care and number of contacts in outpatient care services. The three service types displayed a similar pattern of technical performance, with high relative technical efficiency on average and a low probability of being efficient. The most efficient acute hospital and outpatient care services integrated multidisciplinary teams, while psychiatrists and nurses characterized non-hospital residential care. Conclusions: The results indicated that the number of resources and utilization variables were linearly related to the number of users and that the relative technical efficiency of the services was similar across all types. This suggests homogenous MH management with small variations based on workforce allocation. Therefore, the distribution of workforce capacity should be considered in the development of effective policies and interventions in the southern Finnish MH system.
AB - Background: Long-term mental health (MH) policies in Finland aimed at investing in community care and promoting reforms have led to a reduction in the number of psychiatric hospital beds. However, most resources are still allocated to hospital and community residential services due to various social, economic and political factors. Despite previous research focussing on the number and cost of these services, no study has evaluated the emerging patterns of use, their technical performance and the relationship with the workforce structure. Objective: The purpose of this study was to observe the patterns of use and their technical performance (efficiency) of the main types of care of MH services in the Helsinki-Uusimaa region (Finland), and to analyse the potential relationship between technical performance and the corresponding workforce structure. Methods: The sample included acute hospital residential care, non-hospital residential care and outpatient care services. The analysis was conducted using regression analysis, Monte Carlo simulation, fuzzy inference and data envelopment analysis. Results: The analysis showed a statistically significant linear relationship between the number of service users and the length of stay, number of beds in non-hospital residential care and number of contacts in outpatient care services. The three service types displayed a similar pattern of technical performance, with high relative technical efficiency on average and a low probability of being efficient. The most efficient acute hospital and outpatient care services integrated multidisciplinary teams, while psychiatrists and nurses characterized non-hospital residential care. Conclusions: The results indicated that the number of resources and utilization variables were linearly related to the number of users and that the relative technical efficiency of the services was similar across all types. This suggests homogenous MH management with small variations based on workforce allocation. Therefore, the distribution of workforce capacity should be considered in the development of effective policies and interventions in the southern Finnish MH system.
KW - Decision support system
KW - Finland
KW - Mental healthcare
KW - Relative technical efficiency
KW - Services management
KW - Workforce
UR - http://www.scopus.com/inward/record.url?scp=85174742759&partnerID=8YFLogxK
U2 - 10.1186/s12961-023-01061-y
DO - 10.1186/s12961-023-01061-y
M3 - Article
C2 - 37872626
AN - SCOPUS:85174742759
SN - 1478-4505
VL - 21
SP - 1
EP - 15
JO - Health Research Policy and Systems
JF - Health Research Policy and Systems
IS - 1
M1 - 108
ER -