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

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe

“…In line with the preceding PECUNIA stages, five core health and social care services [ 44 , 45 ] were identified as relevant resource use items for mental health conditions in the health and social care sector and selected for the RUC calculations in the six countries: GP (unit of measurement: per contact), dental care (per contact), nursing home (per night), health-related day-care center (per day), health-related help-line (per contact). These services were described in the DESDE PECUNIA coding system [ 34 ] to ensure comparability across countries and implemented in the PECUNIA RUM instrument [ 38 ].…”

Magnitude of terminological bias in international health services research: a disambiguation analysis in mental health

“…This process included three steps: (I) a systematic review to produce a preliminary listing of service terms based on scientific and grey literature; (II) an expert survey and a consecutive revision for the production of the final listing; (III) disambiguation of the terms included in the final listing adapting the previously tested method of Maciejewski et al (2002). Steps I and II are fully described elsewhere (Fischer et al, 2022;Mayer et al, 2022).They involved three working groups and two expert panels. Working group A included three experts in health economics from the University of Hamburg (PH, AK, CD) that led step I and participated in step II.…”

“…(2002). Steps I and II are fully described elsewhere (Fischer et al ., 2022; Mayer et al ., 2022). They involved three working groups and two expert panels.…”

“…( 2002 ). Steps I and II are fully described elsewhere (Fischer et al ., 2022 ; Mayer et al ., 2022 ).They involved three working groups and two expert panels. Working group A included three experts in health economics from the University of Hamburg (PH, AK, CD) that led step I and participated in step II.…”

A novel set of Austrian reference unit costs for comprehensive societal perspectives consistent with latest European costing methods for economic evaluations

“…As the focus of this article lies on the newly developed cross-sectoral RUCs, we limit the discussion to the results of the valuation stage. Further details on the other steps have been published [ 34 , 35 ] or are planned to be published in the near future [ 30 , 36 ]. Lastly, as the PECUNIA research teams in each country worked on developing unit costs in each sector, regular sharing of the experiences in the calculation process ensured a high degree of cross-country and cross-sectoral harmonization.…”