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REFINEMENT (REsearch on FINancing systems' Effect on the quality of MENTal health care)

The overarching aim of the REFINEMENT project is to look at the relationship between different models of health care financing systems and the extent to which mental health care services can meet the goals of high quality, equity, efficiency and better long term health outcomes. The results of the research will suggest the best practice health care financing models that may be used in different parts of Europe where different mixes of tax, social health insurance, private health insurance and out of pocket payments are used to achieve these goals. Variations in the structure and characteristics of mental health financing systems will be compared in 9 European countries: Italy, Austria, UK, Spain, Norway, Finland, France, Romania and Estonia.

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REFINEMENT (REsearch on FINancing systems' Effect on the quality of MENTal health care)
REFINEMENT (REsearch on FINancing systems' Effect on the quality of MENTal health care)

Mental health is a key priority area for Europe, as evidenced by the publication by the European Commission in June 2008 of its European Pact on Mental Health and Wellbeing. The REFINEMENT project arises from the necessity to compare and standardize the different and elaborate systems of both financing and performance assessment of Mental Health care in Europe, to promote knowledge of how financial systems can be used to support the development of good-quality and efficient services.

REFINEMENT presents four core objectives:

  • To map and describe the structure and characteristics (including incentives) of financing systems for mental health care.
  • To describe various qualitative aspects of service provision relative to differences in mental health financing through a detailed survey of the nine systems.
  • To describe the typical patient pathways through the service system by people with mental health needs, relative to differences in mental health financing through a detailed survey of the nine systems.
  • Based on (1) - (3), to describe financing models and incentive structures conducive to the promotion of effective, accessible and high quality mental health services.

The REFINEMENT project undertakes a mix of quantitative and qualitative analyses in the 9 European countries. In order to analyze the different financing and care systems and their correlated outcomes, it is necessary to ensure that researchers, service planners and policy makers in different regions, countries and at the European level, compare ‘like with like’ and adequately use the data from different services systems. For such a reason, the REFINEMENT project will produce several new tools covering financing and payment systems, service structure, organization, and resources, service patterns and patient pathway and quality in health and social care services and finally a decision support toolkit to aid decision makers in respect of which health care financing arrangements to achieve difference objectives including accessibility, efficiency and quality of care.

The REFINEMENT project has received funding from the European Commission under the Seventh Framework Programme (7FP) and lies within the Specific Programme "Cooperation" - Theme "Health": HEALTH.2010.3.2-1: Financing systems' effect on quality of health care.

The REFINEMENT project is conducted by an experienced team of health economists, mental health service researchers, public health specialists and social care experts from:

  • The University of Verona, Italy (project coordinator)
  • The Ludwig Boltzmann Gesellschaft, Austria
  • London School of Economics and Political Science, UK
  • Terveyden yes Hyvinvoinnin laitos, Finland
  • Asociacion Cientifica Psicost, Spain
  • University of Tartu, Estonia
  • Université Paris XII - Val de Marne, France
  • Institutul the Prognoz Economica, Romania
  • SINTEF, Norway

Key Factors

Project duration

01/01/2011 - 31/12/2013

FACTS ABOUT THE PROJECT

Refinement web site