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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 pocketpayments 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.

Specific objectives

REFINEMENT presents four core objectives to reach in the 9 European countries:

  • To map and describe the characteristics (including incentives) of financing systems for mental health care
  • To describe the outcomes of mental health services, including quality of care relative to differences in mental health financing
  • To describe typical pathways through the health and social care system by people with mental health needs, relative to differences in mental health financing
  • To build a series of health care financing models conducive to the promotion of high quality mental health care associated with better outcomes

Future implications

European policy-makers and providers of care will be able to use the results of the REFINEMENT project and any subsequent analyses using REFINEMENT data collection tools to understand the complexity of the mental health care system and of the structure of interfaces and interconnections between components services including those provided by primary and social care services.

This project will thus provide a tool for policy makers to assess systematically the use of alternative health care financing models in different contextual settings: Eastern versus Western European countries, centralized versus regionalized health care system, public versus private provision, separate versus integrated health budgets.

The project will provide then a suite of tools and mechanisms to use across European countries for mental health system analysis and to adapt to issues concerning other aspects of the health care system.

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