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An Index of Need for Psychiatric Services based on In-patient Utilisation

Published online by Cambridge University Press:  02 January 2018

Peter Smith ,
Trevor A. Sheldon  and
Stephen Martin
Peter Smith
Affiliation:
Department of Management, University of St Andrews KY16 9DY
Trevor A. Sheldon*
Affiliation:
NHS Centre for Reviews and Dissemination, University of York YO1 5DD
Stephen Martin
Affiliation:
Department of Economics and Related Studies, University of York YO1 5DD
*
Professor Trevor A. Sheldon, NHS Centre for Reviews and Dissemination, University of York, York YO1 5DD
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Abstract

Background

The paper describes the development of an index of the relative need for psychiatric services for the purposes of distributing NHS funds in England.

Method

The study is based on an empirical analysis of all psychiatric in-patient completed episodes in England in 1991/92. Any index of need should be independent of the effect of variations in health care supply on the use of psychiatric services. In order to disentangle the influences of supply from social and clinical determinants of utilisation, two stage least squares regression and multilevel modelling techniques were used.

Results

The outcome was an index comprising six health and socio-economic variables. This is now being used by the NHS Executive to distribute about £2.2 billion of annual NHS expenditure for psychiatric services between English health authorities.

Conclusion

It is shown that the index is much more sensitive to needs and therefore more redistributive than the previous index of need used in the NHS.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 3 , September 1996 , pp. 308 - 316
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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