Open AccessHow Much Should We Pay to Deliver Comprehensive Mental and Social Health Services? Experiences from Iran
Author(s) -
Behzad Damari,
Ahmad Hajebi,
Masoud Abolhallaje,
Behzad Najafi
Publication year - 2021
Publication title -
iranian journal of psychiatry.
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.503
H-Index - 17
eISSN - 2008-2215
pISSN - 1735-4587
DOI - 10.18502/ijps.v16i2.5816
Subject(s) - per capita , mental health , activity based costing , business , unit (ring theory) , cost estimate , environmental health , rehabilitation , total cost , medicine , psychology , marketing , psychiatry , economics , population , mathematics education , management , physical therapy , accounting
Objective: Comprehensive mental and social health services is the new benefit package which had been aimed to provide mental health services to people who suffer from mental disorders. The aim of this study was to estimate the cost of plan and its drivers to provide evidence for decision-making by national policymakers.
Method: We used the bottom-up costing approach to estimate the cost of plan. We identified the cost centers, services delivery process, and facilities. Data were collected via different sources and tools such as the new financial system, registration forms, and performance reporting forms. We categorized the cost into 4 groups and selected appropriate measures to estimate the cost. We estimate the total and unit cost for 3 levels in 2 scenarios by considering the 2017 prices.
Results: Screening resulted in 8.9% new detection with a different incidence in urban and rural areas (urban: 16.5%; rural: 2.7%). Also, 61 842 million IRR was spent for the screening, diagnose, treatment, and rehabilitation of detected people in 2017. Personal cost is responsible for 90.6% and primary screening for 66.4% of the total cost.
Conclusion: For the development of the program (from screening to rehabilitation) 530 513 IRR should be spent per capita. The cost of detection per client can vary due to differences in disease prevalence, especially treatment and rehabilitation costs. It is suggested to consider the variation of the prevalence in expanding the plan to the whole country. Integrating the services in primary health care lead to huge cost saving.