The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review

AIMS AND METHOD

This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries.

RESULTS

Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models.

CLINICAL IMPLICATIONS

Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.

[The medical social portrait of consumer of laboratory services of medical organizations]

The article presents information about various medical and social characteristics of the population of the Samara region cities. The survey of respondents was held by the network commercial laboratory, which treatment rooms were opened simultaneously in several cities of the region. The conducted study allowed to compile a medico-social portrait of the customer of laboratory services of medical organizations. It was discovered that laboratory services of commercial laboratories are most commonly used by women (78.1%) between the ages of 18 to 40 years. It was revealed that 54.9% of all patient admissions were repeated, and 56.0% of the patients were tested on their own initiative. The initial application is male-dominated 56.2%. Geographically the most often service was provided in Togliatti city (63.8%). Most prone to doctor's recommendation, to apply for paid medical analyses are patients between ages of 18 to 50 years old. Based on the obtained data a set of measures was proposed aimed to improve the quality of medical laboratory services.