In the current geopolitical environment, in which funding has dramatically diminished for many social service programs, policymakers and social workers have a significant challenge to advocate for social welfare policies, interventions, and treatments that are both cost effective and have the best outcomes. In order to advocate effectively, it is crucial to understand the components that contribute to the cost of mental illness. Information regarding these costs, although they greatly affect policies and public mental health, are not readily represented in the social sciences. The objective of this dissertation is to describe methodological approaches, identify concepts within mental health economics, and address constructs in an attempt to introduce them to the social work field. This dissertation sought to explore and contribute new information to the literature on the direct and indirect economic cost of mental illness and the implications for the field of social work. It will consist of three publishable quality articles that examine issues associated with the economic cost of mental illness. A conceptual paper examining various elements that contextualize the range of economic costs is first utilized. It identifies, defines, and describes the economic cost of mental illness, discusses the history and factors that influence this cost, examine the current state of research including theories and methodological approaches and limitations. Next, an analysis on the range of information technology surrounding mental health and related economic cost is presented. This dissertation article will identify, describe and analyze database sets utilized in economic evaluation. There are four database sets that are the focus of this article. This article will compare, contrast, and critique the datasets on their various components; applicability; and reliability in terms of the usage for economic valuation for planning and evaluation within social work research. Finally, a quantitative study is undertaken that examines how the economy can influence how patients with mental episodes are handled. This study aimed to examine the relationship between State Mental Health Agency expenditures and revenues and its impact on three types of psychiatric admissions: Voluntarily Admitted, Involuntarily Civilly Committed, and Involuntarily Criminally Committed. / text

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Thesis (M.S.)--University of Michigan, 1991.

Thesis (M.S.)--University of Michigan, 1991.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2016-05-11T13:53:44Z No. of bitstreams: 1 Claudia Silva Marinho Antunes Barros Custos... 2016.pdf: 2575504 bytes, checksum: 2b64af2892aa58d02c2b0684383b6826 (MD5) / Approved for entry into archive by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2016-05-11T13:53:53Z (GMT) No. of bitstreams: 1 Claudia Silva Marinho Antunes Barros Custos... 2016.pdf: 2575504 bytes, checksum: 2b64af2892aa58d02c2b0684383b6826 (MD5) / Made available in DSpace on 2016-05-11T13:53:53Z (GMT). No. of bitstreams: 1 Claudia Silva Marinho Antunes Barros Custos... 2016.pdf: 2575504 bytes, checksum: 2b64af2892aa58d02c2b0684383b6826 (MD5) Previous issue date: 2016 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / INTRODUÇÃO: As Infecções de Sítio Cirúrgico (ISCs) são as complicações mais freqüentes que ocorrem nos pacientes após as cirurgias e são responsáveis pela elevação da morbidade, mortalidade e dos custos hospitalares. OBJETIVO: O objetivo deste estudo foi estimar o custo direto adicional associado às ISCs ocorridas no período de 2011 a 2013 em um Hospital Universitário de Salvador, Bahia. Para tanto buscou-se caracterizar a população de pacientes acometidos por ISC, segundo os aspectos sócio-demográficas, condições clínicas e cirurgias realizadas, realizar uma revisão integrativa atualizada da literatura mundial sobre o custo dessas infecções e analisar os custos associados aos cuidados à saúde dos pacientes cirúrgicos segundo presença de ISC. METODOLOGIA: Trata-se se um estudo epidemiológico do tipo caso-controle pareado, realizado com informações dos registros hospitalares dos pacientes. Foram incluídos como população do estudo todos os casos de ISCs em cirurgias eletivas e limpas. Os controles foram pareados por idade, sexo e tipo de cirurgia realizada respeitando o princípio da similaridade. As proporções foram comparadas por meio dos testes 2 e exato de Fisher quando adequados com nível de 5% de significância estatística. Para estimar as diferenças das médias de custos utilizou-se o modelo de regressão linear. RESULTADOS: No total foram selecionados 259 pacientes. Os casos de ISC ocorreram predominantemente em mulheres, com idade entre 61 a 75 anos. Os principais fatores atribuídos aos custos com as ISCs foram o uso de antibióticos para o seu tratamento, a internação em Unidade de Terapia Intensiva, a realização de exames e reabordagens cirúrgicas. No geral, o custo médio hospitalar em pacientes com ISC foi aproximadamente o dobro do valor aferido daqueles não infectados. CONCLUSÕES: Foi evidenciado neste estudo a necessidade de reforçar o desenvolvimento constante de ações preventivas e de controle das ISCs a fim de garantir a segurança na assistência prestada aos pacientes cirúrgicos e conseqüentemente a redução dos custos atribuídos a essa complicação para o hospitais e sistema de saúde. / INTRODUCTION: The Surgical Site Infections (SSI) are the most frequent complications occurring in patients after surgery and are responsible for high morbidity, mortality and hospital costs. OBJECTIVE: The aim of this study was to estimate the additional direct costs associated with SSIs occurred in the 2011-2013 period at a University Hospital in Salvador, Bahia. For that sought to characterize the population of patients affected by ISC, according to the socio-demographic aspects, clinics and surgeries conditions, carry out a integrative and updated review of the literature on the cost of these infections and analyze the costs associated with health care to patients surgical according to the presence of ISC. METHODOLOGY: This is an epidemiological study of the case-control matched, conducted with information from the hospital records of patients. They were included in the study population all cases of ISCs in elective surgery and clean. The controls were matched for age, gender and type of surgery performed respecting the principle of similarity. Proportions were compared using the Fisher's exact test and χ2 when appropriate and at 5% statistical significance. To estimate the differences of the average costs used the linear regression model. RESULTS: In total 259 patients were selected. The cases of ISC occurred primarily in women between 61-75 years. The main factors attributed to the costs of the ISCs were the use of antibiotics for their treatment, to stay in the Intensive Care Unit, conducting exams and news surgical interventions. Overall, the average hospital cost in patients with SSI was approximately twice with those not infected. CONCLUSIONS: It was shown in this study the need of to reinforce the constant development of preventive and control of SSIs in order to secure the assistance provided to surgical patients and therefore reducing costs attributed to this complication for hospitals and health care system.

The aim of the thesis is to analyze the economic profitability of current obstetric facilities in the Czech Republic. The theoretical part deals with economic aspects of health such as health determinants and their effect on human health, the specific of health care and role of the state in health care. Further work is focused on exploring different types of health systems, the principles of financing Czech healthcare system and its development in recent years. Despite the increasing role of direct financing of health care and higher patient participation, the public sector still plays the most important role, which follows from the Charter of Fundamental Rights and Freedoms. Based on available data on infant mortality the efficiency of functioning of the Czech and American health care system will be compared. Infant mortality in the Czech Republic is very low and our country in this regard is placed on the top places in the world. The practical part deals with analysis of the costs of planned caesarean section, including the total time a mother spends in hospital. Furthermore, the practical part deals with the future of obstetrics in the Czech Republic in terms of plans for the closing of small hospitals with low numbers of births and infant homes replacing foster care. The final part deals with births at home as a substitute for births in hospitals. This topic is now getting into media interest when it is discussed to ensure adequate care in childbirth and health risks for mother and newborn.