Skip to main content
×
×
Home

Describing, explaining or predicting mental health care costs: a guide to regression models: Methodological review

  • Graham Dunn (a1), Massimo Mirandola (a2), Francesco Amaddeo (a2) and Michele Tansella (a2)
Abstract
Background

Analysis of the patterns of variation in health care costs and the determinants of these costs (including treatment differences) is an increasingly important aspect of research into the performance of mental health services.

Aims

To encourage both investigators of the variation in health care costs and the consumers of their investigations to think more critically about the precise aims of these investigations and the choice of statistical methods appropriate to achieve them.

Method

We briefly describe examples of regression models that might be of use in the prediction of mental health costs and how one might choose which one to use for a particular research project.

Conclusions

If the investigators are primarily interested in explanatory mechanisms then they should seriously consider generalised linear models (but with careful attention being paid to the appropriate error distribution). Further insight is likely to be gained through the use of two-part models. For prediction we recommend regression on raw costs using ordinary least-square methods. Whatever method is used, investigators should consider how robust their methods might be to incorrect distributional assumptions (particularly in small samples) and they should not automatically assume that methods such as bootstrapping will allow them to ignore these problems.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Describing, explaining or predicting mental health care costs: a guide to regression models
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Describing, explaining or predicting mental health care costs: a guide to regression models
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Describing, explaining or predicting mental health care costs: a guide to regression models
      Available formats
      ×
Copyright
Corresponding author
Professor Graham Dunn, Biostatistics Group, School of Epidemiology & Health Sciences, Stopford Building, Oxford Road, Manchester M13 9PT, UK. E-mail: g.dunn@man.ac.uk
Footnotes
Hide All

Declaration of interest

None.

Footnotes
References
Hide All
Amaddeo F., Beecham J., Bonizzato P., et al (1998) The costs of community-based psychiatric care for first-ever patients. A case register study. Psychological Medicine, 28, 173183.
Armitage P., Berry G. & Matthews J. N. S. (2002) Statistical Methods in Medical Research (4th edn). Oxford: Blackwell.
Barber J. & Thompson S. G. (2000a) Analysis and interpretation of cost data in randomised controlled trials: review of published studies. BMJ, 317, 11951200.
Barber J. & Thompson S. G. (2000b) Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Statistics in Medicine, 19, 32193236.
Berk R. A. (1990) A primer in robust regression. In Modern Methods of Data Analysis (eds Fox J. & Long J. S.), pp. 292324. Newbury Park, CA: Sage Publications.
Bonizzato P., Bisoffi G., Amaddeo F., et al (2000) Community-based mental health care: to what extent are service costs associated with clinical, social and service history variables? Psychological Medicine, 30, 12051215.
Byford S., Barber J. A., Fiander M., et al (2001) Factors that influence the cost of caring for patients with severe psychotic illness. Report from the UK 700 trial. British Journal of Psychiatry, 178, 441447.
Chisholm D. & Knapp M. (2002) The economics of schizophrenia care in Europe: the EPSILON study. Epidemiologia e Psichiatria Sociale, 11, 1217.
Deb P. & Holmes M. (2002) Estimates of use and costs of behavioural health care: a comparison of standard and finite mixture models. In Econometric Analysis of Health Data (eds Jones A. M. & O'Donnell O.), pp. 8799. New York: John Wiley.
Desgagne A., Castilloux A.-M., Angers J. F., et al (1998) The use of the bootstrap statistical method for the pharmacoeconomic cost analysis of skewed data. Pharmacoeconomics, 13, 487497.
Diehr P., Yanez D., Ash A., et al (1999) Methods for analyzing health care utilisation and costs. Annual Review of Public Health, 20, 125144.
Draper N. R. & Smith H. (1998) Applied Regression Analysis (3rd edn). New York: John Wiley.
Duan N. (1983) Smearing estimate: a non-parametric retransformation method. Journal of the American Statistical Association, 78, 605610.
Duan N., Manning W. G. Jr., Morris C. N., et al (1983) A comparison of alternative models for demand for medical care. Journal of Business and Economic Statistics, 1, 115126.
Duan N., Manning W. G. Jr., Morris C. N., et al (1984) Choosing between the sample selection model and the multi-part model. Journal of Business and Economic Statistics, 2, 283289.
Dunn G. (1989) Design and Analysis of Reliability Studies. London: Edward Arnold.
Efron B. & Tibshirani R. J. (1993) An Introduction to the Bootstrap. London: Chapman & Hall.
Everitt B. S. & Dunn G. (2001) Applied Multivariate Data Analysis (2nd edn). London: Edward Arnold.
Greene W. H. (2000) Economic Analysis (4th edn). Englewood Cliffs, NJ: Prentice Hall.
Hoch J. S., Briggs A. H. & Willan A. (2002) Something old, something new, something borrowed, something blue: a framework for the marriage of health econometrics and cost-effectiveness analysis. Health Economics, 11, 415430.
Jones A. M. & O'Donnell O. (2002) Econometric Analysis of Health Data. New York: John Wiley.
Kennedy P. (1998) A Guide to Econometrics (4th edn). Oxford: Blackwell Publishers.
Kilian R., Matschinger H., Löffler W., et al (2002) A comparison of methods to handle skew cost variables in the analysis of the resource consumption in schizophreniatreatment. Journal of Mental Health Policy and Economics, 5, 2131.
Knapp M., Chisolm D., Leese M., et al (2003) Comparing patterns and costs of schizophrenia in five European countries: The EPSILON Study. Acta Psychiatrica Scandinavica, 105, 4254.
Lin L. I.-K. (1989) A concordance correlation coefficient to evaluate reproducibility. Biometrics, 45, 255268.
Mosteller F. & Tukey J. W. (1977) Data Analysis and Regression. Reading, MA: Addison Wesley.
Mullahy J. (1998) Much ado about two: reconsidering retransformation and the two-part model in health econometrics. Journal of Health Economics, 17, 247281.
O'Hagan A. & Stevens J. W. (2003) Assessing and comparing costs: how robust are the bootstrap and methods based on asymptotic normality? Health Economics, 12, 3349.
Picard R. R. & Berk K. N. (1990) Data splitting. American Statistician, 44, 140147.
Sackett D. L., Haynes R. B., Guyatt G. H., et al (1991) Clinical Epidemiology: A Basic Science for Clinical Medicine. Boston, MA: Little Brown.
Stinnett A. A. & Mullahy J. (1998) Net health benefits: a new framework for the analysis of uncertainty in cost-effectiveness analysis. Medical Decision Making, 18 (Pharmacoeconomics special issue), S68S80.
Tambour M., Zethraeas N. & Johannesson M. A. (1998) A note on confidence intervals in cost-effectiveness analysis. International Journal of Technology Assessment in Health Care, 14, 467471.
Theil H. (1966) Applied Economic Forecasting. Amsterdam: North Holland.
Verbeek M. (2000) A Guide to Modern Econometrics. New York: John Wiley.
Wooldridge J. M. (2003) Introductory Econometrics (2nd edn). Madison, OH: South-Western College Publishing.
Zheng B. & Agresti A. (2000) Summarising the predictive power of a generalised linear model. Statistics in Medicine, 19, 17711781.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 3 *
Loading metrics...

Abstract views

Total abstract views: 5 *
Loading metrics...

* Views captured on Cambridge Core between 3rd January 2018 - 24th February 2018. This data will be updated every 24 hours.

Describing, explaining or predicting mental health care costs: a guide to regression models: Methodological review

  • Graham Dunn (a1), Massimo Mirandola (a2), Francesco Amaddeo (a2) and Michele Tansella (a2)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *