The excess economic burden of mental disorders: findings from a cross-sectional prevalence survey in Austria

Abstract

Information about the scope of mental disorders (MDs), resource use patterns in health and social care sectors and economic cost is crucial for adequate mental healthcare planning. This study provides the first representative estimates about the overall utilisation of resources by people with MDs and the excess healthcare and productivity loss costs associated with MDs in Austria. Data were collected in a cross-sectional survey conducted on a representative sample ( n = 1008) between June 2015 and June 2016. Information on mental health diagnoses, 12-month health and social care use, medication use, comorbidities, informal care, early retirement, sick leave and unemployment was collected via face-to-face interviews. Generalised linear model was used to assess the excess cost of MDs. The healthcare cost was 37% higher ( p = 0.06) and the total cost was twice as high ( p < 0.001) for the respondents with MDs compared to those without MDs. Lost productivity cost was over 2.5-times higher ( p < 0.001) for those with MDs. Participants with severe MDs had over 2.5-times higher health and social care cost ( p < 0.001) and 9-times higher mental health services cost ( p < 0.001), compared to those with non-severe MDs. The presence of two or more physical comorbidities was a statistically significant determinant of the total cost. Findings suggest that the overall excess economic burden on health and social care depends on the severity of MDs and the number of comorbidities. Both non-severe and severe MDs contribute to substantially higher loss productivity costs compared to no MDs. Future resource allocation and service planning should take this into consideration.

Understanding the Economic Value and Impacts on Informal Carers of People Living with Mental Health Conditions

“…Recent analysis from a convenience sample survey in Australia looking at time spent caring by family carers for a range of mental health conditions had similar findings to this study; they estimate that primary carers provide on average approximately 36 h of care per week, with 38% caring for 40 or more hours per week [ 3 , 21 , 22 ]. In contrast, a cross-sectional survey in Austria reported very low weekly hours of care of only 2.82 h per week, but this survey only interviewed people living with mental health conditions, rather than their carers [ 36 ]. In the Basque country, in Spain, a convenience sampling survey of more than 200 carers supporting people with eating disorders, depression and schizophrenia, respectively, reported that 44%, 68% and 33% of carers were in contact with the person they support for more than 35 h per week [ 37 ].…”

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

“…Even minor changes in definitions may cause considerable variation in the estimation of disease prevalence and service utilization [4,5]. Another factor is that although the economic burden of mental diseases in regards to costs is thought to be massive [6], resulting in doubled total costs for persons with mental diseases compared to those without [7], calculating exact costs is complicated [8,9]. This is particularly the case if health care provision and funding are both fragmented, such as in Austria [10,11].…”

“…This might be due to the lack of available data and valuation methods [20]. At the same time, these inter-sectoral costs were found to contribute a considerable proportion to the total costs of mental diseases [7,15,21,22]. With economic evaluations being increasingly used as a base for decision making in healthcare, a comprehensive reflection of the societal costs associated with a disease is also vital in this context and has been already recommended in national health economics guidelines in the Netherlands and Spain [23,24].…”

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

“…Similar spill-over costs are also relevant for persons providing informal care to patients [ 19 ]. As health economic evaluations are among the essential groundwork for evidence-informed policy decision making, sensible consideration of a societal perspective is important and has been taken up in recent cost of illness studies [ 20 , 21 ]. However, the quality of intersectoral, i.e., sector overarching, health economic analyses, and the resulting empirical evidence depends critically on the compatibility of the methods used in the cost assessment in the different sectors, in particular with regard to quantifying costs.…”