Establishing a comprehensive list of mental health-related services and resource use items in Austria: A national-level, cross-sectoral country report for the PECUNIA project

• Published in: PloS one Vol. 17; no. 1; p. e0262091
• Main Authors: Fischer, Claudia, Mayer, Susanne, Perić, Nataša, Simon, Judit
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21-01-2022; Public Library of Science (PLoS)
• Subjects: Ambulatory care; Austria; Biology and Life Sciences; Care and treatment; Context; Cost analysis; Cost estimates; Cost of Illness; Crime; Criminal Law; Decision making; Delivery of Health Care; Diagnosis; Disease; Education; Employment; Europe; Health care expenditures; Health care industry; Health care policy; Health economics; Humans; Judicial system; Lists; Literature reviews; Measuring instruments; Medical care; Medicine and Health Sciences; Mental disorders; Mental Disorders - economics; Mental Disorders - prevention & control; Mental health; Mental Health Services - economics; Mental illness; People and Places; Post traumatic stress disorder; Productivity; Psychiatric services; Public health; Risk factors; Social Support; Surveys and Questionnaires; Utilization; Valuation; Austria; Europe; Netherlands; United Kingdom > UK; Germany; Spain
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0262091

A comprehensive, comparable assessment of the economic disease burden and the value of relevant care forms a major challenge in the case of mental diseases. This study aimed to inform the development of a resource use measurement (RUM) instrument and harmonized reference unit costs valid for multi-sectoral and multi-national cost assessments for mental health diseases as part of the European PECUNIA project.
An iterative, multi-methods approach was applied. Systematic literature reviews appended with national grey literature searches in six European countries were conducted to generate preliminary, literature-based, international, mental health-related service and resource use lists for all investigated sectors in 2018. As part of a multi-national expert survey, these lists were reviewed by 18 Austrian sector-specific experts regarding the clarity, relevance, comprehensiveness and availability in the Austrian context.
Out of 295 items included in the preliminary, international, sector-specific lists (health and social care-201 items, criminal justice-35 items, education-39 items; patient, family and informal care-20 items), a total of 261 items and descriptions (88%) were considered clear by all experts. 42 items (14%) were considered not existing in Austria, and 111 items (38%) were prioritized regarding their relevance in the national context. Thirteen additional items (4%) were suggested to be added to accommodate for Austria-specific features of the individual sectors. Major typological difficulties based on item names were observed.
The identified country-specific variations and general typological bias and their potential contributions to service and resource use cost variations across countries and sectors call for further systematic investigation. Next, PECUNIA will develop internationally harmonized and comparable definitions of the listed items and their units of analysis based on a new conceptual multi-sectoral costing framework. The developed lists will require consolidation and further prioritization for the development of a patient-reported RUM instrument and consequent reference unit cost valuation.