Evidence map›Paper›PMID 38561766›Full record

ArticleBMC health services research2024

An exploration of service use pattern changes and cost analysis following implementation of community perinatal mental health teams in pregnant women with a history of specialist mental healthcare in England: a national population-based cohort study.

Emma Tassie, Julia Langham, Ipek Gurol-Urganci, Jan van der Meulen, Louise M Howard, Dharmintra Pasupathy, Helen Sharp, Antoinette Davey, Heather O'Mahen, Margaret Heslin and 1 more

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Emma TassieKing's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. emma.tassie@kcl.ac.uk.
Julia LanghamDepartment of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London, UK.
Ipek Gurol-UrganciDepartment of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London, UK.
Jan van der MeulenDepartment of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London, UK.
Louise M HowardSection of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Dharmintra PasupathyReproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Helen SharpDepartment of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
Antoinette DaveyFaculty of Life and Environmental Sciences, Department of Psychology, University of Exeter, Perry Road, Prince of Wales Road, Exeter, UK.
Heather O'MahenFaculty of Life and Environmental Sciences, Department of Psychology, University of Exeter, Perry Road, Prince of Wales Road, Exeter, UK.
Margaret Heslin *King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Sarah Byford *King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
King's College London · GBLondon School of Hygiene & Tropical Medicine · GBUniversity of Exeter · GBThe University of Sydney · AUUniversity of Liverpool · GB

Funding

National Institute for Health and Care Research, UK 17/49/38
6 · The paper itself

Abstract

backgroundThe National Health Service in England pledged >£365 million to improve access to mental healthcare services via Community Perinatal Mental Health Teams (CPMHTs) and reduce the rate of perinatal relapse in women with severe mental illness. This study aimed to explore changes in service use patterns following the implementation of CPMHTs in pregnant women with a history of specialist mental healthcare in England, and conduct a cost-analysis on these changes.

methodsThis study used a longitudinal cohort design based on existing routine administrative data. The study population was all women residing in England with an onset of pregnancy on or after 1st April 2016 and who gave birth on or before 31st March 2018 with pre-existing mental illness (N = 70,323). Resource use and costs were compared before and after the implementation of CPMHTs. The economic perspective was limited to secondary mental health services, and the time horizon was the perinatal period (from the start of pregnancy to 1-year post-birth, ~ 21 months).

resultsThe percentage of women using community mental healthcare services over the perinatal period was higher for areas with CPMHTs (30.96%, n=9,653) compared to areas without CPMHTs (24.72%, n=9,615). The overall percentage of women using acute care services (inpatient and crisis resolution teams) over the perinatal period was lower for areas with CPMHTs (4.94%, n=1,540 vs. 5.58%, n=2,171), comprising reduced crisis resolution team contacts (4.41%, n=1,375 vs. 5.23%, n=2,035) but increased psychiatric admissions (1.43%, n=445 vs. 1.13%, n=441). Total mental healthcare costs over the perinatal period were significantly higher for areas with CPMHTs (fully adjusted incremental cost £111, 95% CI £29 to £192, p-value 0.008).

conclusionsFollowing implementation of CPMHTs, the percentage of women using acute care decreased while the percentage of women using community care increased. However, the greater use of inpatient admissions alongside greater use of community care resulted in a significantly higher mean cost of secondary mental health service use for women in the CPMHT group compared with no CPMHT. Increased costs must be considered with caution as no data was available on relevant outcomes such as quality of life or satisfaction with services.

Indexed as

Mental Health ServicesPregnant PeopleCohort StudiesFemaleHealth Care CostsHumansMental HealthParturitionPregnancyQuality of LifeState MedicineCostsHealth service useMental healthPerinatal

Identifiers

PMID38561766
PMCPMC10983755
OpenAlexW4393378379

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.