Costs of Mental Health Services in Czechia: Facilitating an Evidence-Based Reform of Psychiatric Care
Abstrakt
Background:Information about unit costs of psychiatric care is largely unavailable in Central and Eastern Europe, whichposes an obstacle to economic evaluations as well as evidence-based development of the care in the region.Objective:The objective of this study was to calculate the unit costs of inpatient and community mental healthservices in Czechia and to assess the current practices of data collection by mental healthcare providers.Methods:We used bottom-up microcosting to calculate unit costs from detailed longitudinal accounts and recordskept by three psychiatric hospitals and three community mental health providers.Results:An inpatient day in a psychiatric hospital costs 1504 Czech Republic koruna (CZK; EUR59), out of which75% is consumed by hotel services and the rest by medication and therapies. The costed inpatient therapiesinclude individual therapies provided by a psychiatrist or psychologist, consultations with a social worker,group therapies, organised cultural activities and training activities.
As regards the community setting, wecosted daycare social facilities, case management services, sheltered housing, supported housing, crisishelp, social therapeutic workshops, individual placement and support, and self-help groups.Conclusions:The unit costs enable assigning financial value to individual items monitored by the Czech version of theClient Service Receipt Inventory, and thus estimation of costs associated with treatment of mental healthproblems. The employed methodology might serve as a guideline for the providers to improve datacollection and to calculate costs of services themselves, with this information likely becoming more crucialfor payers in the future.