Psychiatric health care and costs under comprehensive public health insurance: experience in a Canadian province.

Psychiatric service delivery was studied over a 6-year period in the Province of Saskatchewan, which has had comprehensive universal medical insurance since 1962. That experience is relevant to current issues of costs and quality of care, methods of financial reimbursement and organization of service delivery. A unique patient-centered data base permitted the examination of significant differences between the private and public service delivery sectors in volumes and types of patients treated as well as treatment costs. A dominant picture emerged of distinct types of patients that differ significantly in terms of severity and duration of illness, as well as in the amount of resources they consume. Their differing needs for intervention and prevention should be taken into account in mental health care planning.