Direct and Indirect Management Models in Public Health in the Framework of Mental Health
Abstract
1. Introduction
2. Methodology
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Jagrič, T.; Brown, C.; Boyce, T.; Jagrič, V. The impact of the health-care sector on national economies in selected European countries. Health Policy 2021, 125, 90–97. [Google Scholar] [CrossRef] [PubMed]
- Organisation for Economic Cooperation and Development. Health at a Glance, Europe 2018. State of Health in the EU Cycle; OECD Publishig: París, France, 2018; p. 212. [Google Scholar]
- González-Rodríguez, A.; Labad, J. Salud mental en tiempos de la COVID: Reflexiones tras el estado de alarma. Med. Clín. 2020, 155, 392–394. [Google Scholar] [CrossRef]
- Hernández Rodríguez, J. Impacto de la COVID-19 sobre la salud mental de las personas. Medicentro Electron. 2020, 24, 578–594. [Google Scholar]
- Ramírez-Ortiz, J.; Castro-Quintero, D.; Lerma-Córdoba, C.; Yela-Ceballos, F.; Escobar-Córdoba, F. Mental health consequences of the COVID-19 pandemic associated with social isolation. Colomb. J. Anesthesiol. 2020, 48, e930. [Google Scholar] [CrossRef]
- Jané-Llopis, E. La eficacia de la promoción de la salud mental y la prevención de los trastornos mentales. Rev. Asoc. Esp. Neuropsiq. 2004, 89, 67–77. [Google Scholar] [CrossRef]
- Angermeyer, M.C.; Dietrich, S. Public beliefs about and attitudes towards people with mental illness: A systematic review of population studies. Acta Psychiatr. Scand. 2006, 113, 163–179. [Google Scholar] [CrossRef]
- Rathmann, K.; Pförtner, T.K.; Osorio, A.M.; Hurrelmann, K.; Elgar, F.J.; Bosakova, L.; Ritcher, M. Adolescents’ psychological health during the economic recession: Does public spending buffer health inequalities among young people? BMC Public Health 2016, 16. [Google Scholar] [CrossRef] [PubMed]
- Kessler, R.C.; Angermeyer, M.; Anthony, J.C.; De Graaf, R.; Demyttenaere, K.; Gasquet, I.; De Girolamo, G.; Gluzman, S.; Gureje, O.; Haro, J.M.; et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry 2007, 6, 168–176. [Google Scholar]
- La OMS Destaca la Necesidad Urgente de Transformar la Salud Mental y la Atención de la Salud Mental. Available online: https://www.who.int/news/item/17-06-2022-who-highlights-urgent-need-to-transform-mental-health-and-mental-health-care (accessed on 16 December 2022).
- Organización Mundial de la Salud. Informe Sobre la Salud en el Mundo 2001. Salud Mental: Nuevos Conocimientos, Nuevas Esperanzas; OMS: Ginebra, Suiza, 2001; p. 169.
- Organización Mundial de la Salud. Invertir en Salud Mental; OMS: Ginebra, Suiza, 2004; p. 52.
- Organización Mundial de la Salud. La Inversión en el Tratamiento de la Depresión y la Ansiedad Tiene un Rendimiento del 400%. Available online: https://www.who.int/es/news-room/detail/13-04-2016-investing-in-treatment-for-depression-and-anxiety-leads-to-fourfold-return (accessed on 15 August 2019).
- Kessler, R.C.; Berglund, P.; Demler, O.; Jin, R.; Merikangas, K.R.; Walters, E.E. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch. Gen. Psychiatry 2005, 62, 593–602. [Google Scholar] [CrossRef]
- Regional Mental Health Atlas. December 2015. Available online: https://iris.paho.org/handle/10665.2/28450?locale-attribute=en (accessed on 16 December 2022).
- Almeida-Filho, N. Desigualdades en salud: Nuevas perspectivas teóricas. Salud. Colect. 2020, 16, e2751. [Google Scholar] [CrossRef]
- Bloom, D.E.; Cafiero, E.T.; Jané-Llopis, E.; Abrahams-Gessel, S.; Bloom, L.R.; Fathima, S.; Feigl, A.B.; Gaziano, T.; Hamandi, A.; Mowafi, M.; et al. The Global Economic Burden of Noncommunicable Diseases. PGDA Work Pap. 2011, 8712, 15–18. [Google Scholar]
- Torres De Galvis, Y. Costos asociados con la salud mental. Rev. Cienc. Salud. 2018, 16, 82–87. [Google Scholar]
- Yamey, G.; Beyeler, N.; Wadge, H.; Jamison, D. Invirtiendo en salud: El argumento económico. Informe del Foro sobre Inversión en Salud de la Cumbre Mundial sobre Innovación para la Salud 2016. Salud. Publ. Mex. 2017, 59, 321–342. [Google Scholar] [CrossRef] [PubMed]
- Ruiz-Pérez, I.; Bermúdez-Tamayo, C.; Rodríguez-Barranco, M. Socio-economic factors linked with mental health during the recession: A multilevel analysis. Int. J. Equity Health 2017, 16, 1–8. [Google Scholar] [CrossRef]
- Stadhouders, N.; Kruse, F.; Tanke, M.; Koolman, X.; Jeurissen, P. Effective healthcare cost-containment policies: A systematic review. Health Policy 2019, 123, 71–79. [Google Scholar] [CrossRef]
- García-Gómez, P.; Jiménez-Martín, S.; Labeaga, J.M. Consequences of the Economic Crisis on Health and Health Care Systems. Health Econ. 2016, 25, 3–5. [Google Scholar] [CrossRef] [PubMed]
- Braendle, T.; Colombier, C. What drives public health care expenditure growth? Evidence from Swiss cantons, 1970–2012. Health Policy 2016, 120, 1051–1060. [Google Scholar] [CrossRef]
- Onocko-Campos, R.; Davidson, L.; Desviat, M. Salud mental y derechos humanos: Desafíos para servicios de salud y comunidades. Salud. Colect. 2021, 17, e3488. [Google Scholar] [CrossRef]
- Ruiz-Rodríguez, P.; Cano-Vindel, A.; Muñoz Navarro, R.; Menandro, L.; Moriana, J.A.; Buiza Aguado, C.; Jiménez Cabré, G.; Gonzlález-Blanch, C. Grupo de Investigación PsicAP. Impacto económico y carga de los trastornos mentales comunes en España: Una revisión sistemática y crítica. Ansiedad. Estrés. 2017, 23, 118–123. [Google Scholar] [CrossRef]
- Buitrago Ramírez, F.; Ciurana Misol, R.; Fernández Alonso, M.C.; Tizón García, J.L.; Grupo de Salud Mental del PAPPS. Salud mental en epidemias: Una perspectiva desde la Atención Primaria de Salud española. Aten. Primaria 2020, 52, 93–113. [Google Scholar] [CrossRef]
- Moncho, J.; Pereyra-Zamora, P.; Tamayo-Fonseca, N.; Giron, M.; Gómez-Beneyto, M.; Nolasco, A. Is recession bad for your mental health? The answer could be complex: Evidence from the 2008 crisis in Spain. BMC Med. Res. Methodol. 2018, 18, 78. [Google Scholar] [CrossRef] [PubMed]
- Wang, H.; Wang, C.; Halliday, T.J. Health and health inequality during the great recession: Evidence from the PSID. Econ. Hum. Biol. 2018, 29, 17–30. [Google Scholar] [CrossRef] [PubMed]
- Dhrifi, A. Gastos en salud, crecimiento económico y mortalidad infantil: Antecedentes de países desarrollados y en desarrollo. Rev. CEPAL 2018, 125, 72–97. [Google Scholar] [CrossRef]
- Salvador, M.R.; Krane, S.; Schelling, J.; Regife, V. Diferencias y similitudes en la Medicina de Familia de los sistemas sanitarios en Alemania y España. Aten. Primaria 2016, 48, 131–135. [Google Scholar] [CrossRef]
- Abimbola, S.; Baatiema, L.; Bigdeli, M. The impacts of decentralization on health system equity, efficiency and resilience: A realist synthesis of the evidence. Health Policy Plan. 2019, 34, 605–617. [Google Scholar] [CrossRef]
- Espinoza-González, A.; Delaney, B.; Marti, J.; Darzi, A. The role of the state in financing and regulating primary care in Europe: A taxonomy. Health Policy 2021, 125, 168–176. [Google Scholar] [CrossRef] [PubMed]
- Palm, W.; Webb, E.; Hernández-Quevedo, C.; Scarpetti, G.; Lessof, S.; Siciliani, L.; van Ginneken, E. Gaps in coverage and access in the European Union. Health Policy 2021, 125, 341–350. [Google Scholar] [CrossRef]
- Ministry of Health. 2018 Annual Report on the National Health System, Executive Summary; Ministerio de Sanidad, Secretaría General Técnica: Madrid, Spain, 2018; pp. 8–10.
- Ministerio de Sanidad y Política Social. National Health System of Spain 2010; Ministerio de Sanidad y Política Social, Centro de Publicaciones: Madrid, Spain, 2010; p. 8.
- Sánchez-Sagrado, T. La atención primaria fuera de nuestras fronteras. La atención primaria en Italia. SEMERGEN 2018, 44, 50–53. [Google Scholar] [CrossRef]
- Fernández del Río, M.P. La medicina de familia en seis países europeos. Aten. Primaria 2020, 42, 620–625. [Google Scholar] [CrossRef][Green Version]
- Giudizio di Parificazione sul Rendiconto Generale della Regione Lombardia Relativo all’Esercizio 2019. Corte dei Conti. Available online: https://webcache.googleusercontent.com/search?q=cache:OuCLoyfFBM4J:https://www.frrb.it/systemFiles/amministrazione_trasparente_/maggio_2021/giudizio_di_parificazione_2019.pdf&cd=1&hl=es-419&ct=clnk&gl=ar (accessed on 25 October 2021).
- Fernández, P. Valoración de Empresas; Gestión 2000: Barcelona, Spain, 1999; pp. 46–48. [Google Scholar]
- Soriano, M.J. Introducción a la Contabilidad y las Finanzas; Profit editorial: Barcelona, Spain, 2010; pp. 21–22. [Google Scholar]
- Brealey, R.; Myers, S.; Allen, F. Principios de Finanzas Corporativas; McGraw-Hill: Mexico City, Mexico, 2010; pp. 64–69. [Google Scholar]
- González Pascual, J. Análisis de la Empresa a Través de su Información Económico-Financiera. Fundamentos Teóricos y Aplicaciones; Ediciones Pirámide: Madrid, Spain, 2016; p. 680. [Google Scholar]
- Puerta, F.; Vergara, J.; Huertas, N. Análisis Financiero: Enfoques en su evolución. Criterio Libre 2018, 16, 85–104. [Google Scholar] [CrossRef]
- La Central de Balanços del Servei Català de la Salut. Available online: http://hdl.handle.net/11351/1187 (accessed on 8 August 2019).
- Florido, F.; García-Agua, N.; Martín, A.; García, A.J. Crisis, gasto público sanitario y política. Rev. Esp. Salud. Pública 2019, 93, e1–e13. [Google Scholar]
- López-Casasnovas, G. La crisis económica española y sus consecuencias sobre el gasto social. Informe SESPAS 2014. Gac. Sanit. 2014, 28 (Suppl. S1), 18–23. [Google Scholar] [CrossRef] [PubMed]
- Presupuestos Generales de la Comunidad Autónoma de Euskadi. Available online: http://www.euskadi.eus/k28aVisWar/k28aIdeES.jsp (accessed on 9 April 2020).
- Economía, PIB y PIB per Cápita, Serie 2000-2018. Available online: https://www.ine.es/dyngs/INEbase/es/operacion.htm?c=Estadistica_C&cid=1254736167628&menu=resultados&idp=1254735576581#!tabs-1254736158133 (accessed on 14 April 2020).
- Ingresos y Gastos. Por Tipos de Concierto y Tipos de Hospital. Available online: https://www.idescat.cat/pub/?id=aec&n=840&lang=es (accessed on 9 April 2020).
- Cervero-Liceras, F.; McKee, M.; Legido-Quigley, H. The effects of the financial crisis and austerity measures on the Spanish health care system: A qualitative analysis of health professionals’ perceptions in the region of Valencia. Health Policy 2015, 119, 100–106. [Google Scholar] [CrossRef] [PubMed]
- Rathmann, K.; Pförtner, T.K.; Hurrelmann, K.; Osorio, A.M.; Bosakova, L.; Elgar, F.J.; Richter, M. The great recession, youth unemployment and inequalities in psychological health complaints in adolescents: A multilevel study in 31 countries. Int J Public Health 2016, 61, 809–819. [Google Scholar] [CrossRef] [PubMed]
Variables | Description |
---|---|
Asset Turnover | Income/sales generated in relation to the investment in assets |
Cash Flow | Net profit plus the amortizations |
GDP Per Capita | GDP per capita (or GDP per inhabitant), is the result of dividing GDP by the number of inhabitants |
Expenditure Per Inhabitant | Expenditures from the public sector, both in acquiring goods and services and in providing services |
Expenditure as % GDP | The weight of public spending on GDP |
Normality Test | |||||||
---|---|---|---|---|---|---|---|
Regions | Kolmogorov–Smirnov a | Shapiro-Wilk | |||||
Statistics | gl | Sig. | Statistics | gl | Sig. | ||
1 | Asset Turnover | 0.256 | 12 | 0.029 | 0.858 | 12 | 0.046 |
Cash_flow | 0.210 | 12 | 0.152 | 0.937 | 12 | 0.461 | |
GDP Per Capita | 0.133 | 12 | 0.200 * | 0.956 | 12 | 0.725 | |
Expenditure as % GDP | 0.163 | 12 | 0.200 * | 0.946 | 12 | 0.576 | |
2 | Asset Turnover | 0.168 | 12 | 0.200 * | 0.940 | 12 | 0.510 |
Cash_flow | 0.344 | 12 | 0.000 | 0.647 | 12 | 0.000 | |
GDP Per Capita | 0.137 | 12 | 0.200 * | 0.948 | 12 | 0.610 | |
Expenditure as % GDP | 0.243 | 12 | 0.548 | 0.836 | 12 | 0.525 |
Mean/Std. Error | Median | Variance | Std. Deviation | Interquartile Range | |
---|---|---|---|---|---|
Expenditure Per Inhabitant | 1314.72/24.48 | 1340.53 | 7193.495 | 84.81 | 137.07 |
Asset Turnover | 0.956/0.0284 | 0.935 | 0.010 | 0.098 | 0.185 |
Cash Flow | 26,302,103.25/904,381.830 | 26,793,509.00 | 9,814,877,937,676.205 | 3,132,870.559 | 3,370,855 |
GDP Per Capita | 201,597.58/2651.217 | 200,923.00 | 84,347,438.083 | 9184.086 | 12,947 |
Expenditure as % GDP | 4.77/0.085 | 4.758 | 0.087 | 0.295298734 | 0.377169 |
Mean/Std. Error | Median | Variance | Std. Deviation | Interquartile Range | |
---|---|---|---|---|---|
Expenditure Per Inhabitant | 1575.46/35.69 | 1606.69 | 15,293.350 | 123.66 | 107.523718 |
Asset Turnover | 1.928/0.041168737775 | 0.0411 | 0.020 | 0.142 | 0.267 |
Cash Flow | 31,643,493.83/ 4,276,898.160 | 4,276,898.160 | 219,502,294,447,988.700 | 14,815,609.824 | 6,928,505 |
GDP Per Capita | 29,713.08/335.881 | 29,509.50 | 1,353,795.720 | 1163.527 | 1867 |
Expenditure as % GDP | 5.230/0.104 | 5.385 | 0.130 | 0.360 | 0.438067 |
Correlations | |||||||
---|---|---|---|---|---|---|---|
Model for Regions where Management by Agreement Prevails | Asset Turnover | Cash Flow | GDP Per Capita | Expenditure Per Inhabitant | Expenditure as % GDP | ||
Spearman’s Rho | Asset Turnover | Correlation coefficient | 1.000 | 0.063 | 0.294 | 0.343 | −0.070 |
Sig. (bilateral) | 0.846 | 0.354 | 0.276 | 0.829 | |||
N | 12 | 12 | 12 | 12 | 12 | ||
Cash Flow | Correlation coefficient | 0.063 | 1.000 | 0.350 | 0.643 * | 0.413 | |
Sig. (bilateral) | 0.846 | 0.265 | 0.024 | 0.183 | |||
N | 12 | 12 | 12 | 12 | 12 | ||
GDP Per Capita | Correlation coefficient | 0.294 | 0.350 | 1.000 | 0.629 * | −0.119 | |
Sig. (bilateral) | 0.354 | 0.265 | 0.028 | 0.713 | |||
N | 12 | 12 | 12 | 12 | 12 | ||
Expenditure Per Inhabitant | Correlation coefficient | 0.343 | 0.643 * | 0.629 * | 1.000 | 0.552 | |
Sig. (bilateral) | 0.276 | 0.024 | 0.028 | 0.063 | |||
N | 12 | 12 | 12 | 12 | 12 | ||
Expenditure as % GDP | Correlation coefficient | −0.070 | 0.413 | −0.119 | 0.552 | 1.000 | |
Sig. (bilateral) | 0.829 | 0.183 | 0.713 | 0.063 | |||
N | 12 | 12 | 12 | 12 | 12 |
Correlations | |||||||
---|---|---|---|---|---|---|---|
Model for Regions with Direct Management | Asset Turnover | Cash Flow | GDP Per Capita | Expenditure Per Inhabitant | Expenditure as % GDP | ||
Spearman’s Rho | Asset Turnover | Correlation coefficient | 1.000 | 0.014 | 0.546 | 0.776 ** | 0.329 |
Sig. (bilateral) | 0.966 | 0.066 | 0.003 | 0.297 | |||
N | 12 | 12 | 12 | 12 | 12 | ||
Cash Flow | Correlation coefficient | 0.014 | 1.000 | −0.301 | 0.084 | 0.580 * | |
Sig. (bilateral) | 0.966 | 0.341 | 0.795 | 0.048 | |||
N | 12 | 12 | 12 | 12 | 12 | ||
GDP Per Capita | Correlation coefficient | 0.546 | −0.301 | 1.000 | 0.539 | −0.028 | |
Sig. (bilateral) | 0.066 | 0.341 | 0.070 | 0.931 | |||
N | 12 | 12 | 12 | 12 | 12 | ||
Expenditure Per Inhabitant | Correlation coefficient | 0.776 ** | 0.084 | 0.539 | 1.000 | 0.671 * | |
Sig. (bilateral) | 0.003 | 0.795 | 0.070 | 0.017 | |||
N | 12 | 12 | 12 | 12 | 12 | ||
Expenditure as % GDP | Correlation coefficient | 0.329 | 0.580 * | −0.028 | 0.671 * | 1.000 | |
Sig. (bilateral) | 0.297 | 0.048 | 0.931 | 0.017 | |||
N | 12 | 12 | 12 | 12 | 12 |
Model Summary | ||||
---|---|---|---|---|
Model | R | R2 | Adjusted R2 | Standard Error of the Estimate |
2 | 0.873 b | 0.762 | 0.709 | 45.745740877 |
Model Summary | ||||
---|---|---|---|---|
Model | R | R2 | Adjusted R2 | Standard Error of the Estimate |
4 | 0.940 d | 0.884 | 0.858 | 46.564318114 |
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Puerto-Casasasnovas, E.; Galiana-Richart, J.; Mastrantonio-Ramos, M.P.; López-Muñoz, F.; Rocafort-Nicolau, A. Direct and Indirect Management Models in Public Health in the Framework of Mental Health. Int. J. Environ. Res. Public Health 2023, 20, 2279. https://doi.org/10.3390/ijerph20032279
Puerto-Casasasnovas E, Galiana-Richart J, Mastrantonio-Ramos MP, López-Muñoz F, Rocafort-Nicolau A. Direct and Indirect Management Models in Public Health in the Framework of Mental Health. International Journal of Environmental Research and Public Health. 2023; 20(3):2279. https://doi.org/10.3390/ijerph20032279
Chicago/Turabian StylePuerto-Casasasnovas, Elena, Jorge Galiana-Richart, María Paola Mastrantonio-Ramos, Francisco López-Muñoz, and Alfredo Rocafort-Nicolau. 2023. "Direct and Indirect Management Models in Public Health in the Framework of Mental Health" International Journal of Environmental Research and Public Health 20, no. 3: 2279. https://doi.org/10.3390/ijerph20032279
APA StylePuerto-Casasasnovas, E., Galiana-Richart, J., Mastrantonio-Ramos, M. P., López-Muñoz, F., & Rocafort-Nicolau, A. (2023). Direct and Indirect Management Models in Public Health in the Framework of Mental Health. International Journal of Environmental Research and Public Health, 20(3), 2279. https://doi.org/10.3390/ijerph20032279