| Summary: | 碩士 === 亞洲大學 === 健康管理研究所 === 94 === Factors Affecting Mental Health Care System Performance
Among OECD countries and Taiwan
Howard Kant Lee
Mental health is the foundation for well-being and effective functioning for an individual and a community. With the rising needs of mental health, most health authorities have not given equivalent attention to mental health proportional to its demand. The purpose of this study is to explore the global determinants of mental health care performance and the relative efficiency of various mental health care systems in OECD countries based on per capita GDP and various health system policies as well as the mental health resource generation and indicators of outcome. Additionally, the comparison between the obtained global statistics and those of Taiwanese mental health system will also be included. This is a cross-sectional study analyzing secondary data extracted from official data base of WHO and DOH Taiwan.
This research endeavors to explore the extent of influence of economy development, mental health policy, total HE as percentage of GDP toward funding of mental health (percentage of total HE on mental health) based on Database of WHO in OECD countries and DOH Taiwan. Furthermore, the extent of influence of the above variables toward mental health resource generation ( total psychiatric beds and personnel ) as well as the influence of all the aforementioned variables toward mental health outcome (DALY and suicide rate) were explored using stepwise multiple regression.
The result shows that 1) Total HE as % of GDP has significant influence on DALY of neuro-psychiatric disorders (Adjusted R2 =0.198, p<0.01). 2) Total psychiatric beds per 10,000 population has significant influence on the suicide rate (Adjusted R2 =0.208, p<0.01). 3) Per capita GDP (purchasing power parity) has significant influence on total psychiatric personnel (Adjusted R2 =0.149, p<0.05). 4) Per capita GDP (purchasing power parity) has significant influence on percentage of total HE on mental health (Adjusted R2 =0.120, p<0.05). 5) Per capita GDP (purchasing power parity) has significant influence on Total HE as % of GDP (Adjusted R2 =0.138, p<0.05). Mental health policy also has moderate influence on total HE as % of GDP, with p<0.1.
Comparison of actual value and predictive value of mental health in Taiwan shows that 1) The actual DALY value is 147770 more than the predictive DALY value .2) The actual suicide rate is 2.50 more than the predictive suicide rate. 3) The actual number of psychiatric personnel is 68.01 less than the predictive number per 100,000 population . 4) The actual value for total HE on health as percentage of GDP is 2.49% less than the predictive value.
In summary, national economy (Per capita GDP) exert positive effect both on total health expenditures and mental health expenditures.
With regard to the performance of mental health care system in Taiwan, although it spend less expenditure as percentage of GDP to generate more general health utilizations (outpatient visits and admissions) as noted in the previous study by Yaung et al., Taiwan mental health care system perform less well in DALY and suicide rate than predicted according to the model. Apparently, the psychiatric professionals in Taiwan are also under–staffed.
Further research focus on mental health resource distribution and utilization and policy implication are suggested.
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