Lowering Treatment Intensities in order to Increase Patient Access to Specialized Mental Health Care Services-A case study of five District Psychiatric Centers (DPCs)

Background One major challenge facing most specialized mental health care services is that demand for treatment exceeds supply, resulting in many individuals with psychiatric disorders remaining untreated even when effective treatments exist. The lack of treatment results in decreased health-related quality of life, increased long term sick leave, and the risk of suicide. In order to improve patient access, decisions have to be made on how to allocate the limited resources. Aim This study aims to investigate the consequences of changing the way current resources are distributed in order to increase patient access. Methods The means of lowering (average) treatment intensity (i.e. each patient receiving fewer consultations) was used to improve patient access by transferring consultations from those that received treatment in 2007 (insiders) to those that did not receive treatment (outsiders). Calculations on what reductions in average treatment intensities were needed to reach refusal rate levels at 10%. Results This method is applied for outpatient clinics of five District Psychiatric Centers (DPCs) supplying specialized mental health care services for adults. Given an average treatment intensity for outsiders being equal to 5 consultations, the average treatment intensity of insiders (those receiving more than 5 consultations) had to be reduced by from 1.86% to 6.55% in order to reach a DPC refusal rate level at 10%. Given an average treatment intensity for outsiders being set at 10 consultations, the same figures became from 3.71% to 13.1%.