Costs of Mental Health Services in Czechia: Facilitating an Evidence-Based Reform of Psychiatric Care

Background Information about unit costs of psychiatric care is largely unavailable in Central and Eastern Europe, which poses 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 health services 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 records kept by three psychiatric hospitals and three community mental health providers. Results An inpatient day in a psychiatric hospital costs 1504 Czech koruna (CZK; €59), out of which 75% is consumed by hotel services and the rest by medication and therapies. The costed inpatient therapies include 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, we costed daycare social facilities, case management services, sheltered housing, supported housing, crisis help, 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 the Client Service Receipt Inventory, and thus estimation of costs associated with treatment of mental health problems. The employed methodology might serve as a guideline for the providers to improve data collection and to calculate costs of services themselves, with this information likely becoming more crucial for payers in the future.