Background The integration of core packages of mental health care into routine primary health care has been introduced as an effective way to achieve universal health coverage in mental health care. Based on the transition of mental health care in Iran, from introducing basic mental health care in PHC to the experience of community-based mental health centers for urban areas, a new socio-mental health service model has been so far proposed. This study aimed to estimate the impact of scaling-up the new socio-mental health model at the national level as well as its associated costs. Methods This study was an economic evaluation following One Health Tool methodology. The data required for the study were collected in the first quarter of the year 2020 with a time horizon from 2020 to 2030. The selected metric for summarizing health effects is healthy life years gained. Resources used in terms of drug and supply, staff salaries and outpatient visits were documented and associated costs were subsequently estimated in order to estimate the average cost of each intervention per case. Results The health impacts are calculated in terms of healthy life years gained for 2020-30, after adjusting the prevalence and incidence rates for each disorder. In total, 1,702,755 healthy life years were expected to be gained. Considering total 1,913,325,408 US dollars cost in base case scenario, each healthy life years gained will cost around 1124 US dollars. Based on the WHO criteria for cost-effectiveness threshold, all of the values ranged from 1042 to 1150 US dollars obtained through eight different scenarios were considered as cost-effective given the GDP per capita of 5506 US dollars for Iran in 2019. Conclusions The present study provided a timely analysis as the ministry of health in Iran sought to implement an ambitious plan of mental care scaling-up across the country. Therefore, this work could make a useful contribution to state-level deliberations on the implementation of this plan. Expanding such works beyond the mental health to all non-communicable diseases and making comparisons between packages of cares can be thus great evidence while the programs are aimed to be scaled-up.
Population aging has increased the need for long-term care of older persons who suffer from multi-morbidity and chronic conditions. Today, the majority of older people are living alone in their home in which they try to cope with highly risky conditions such as sensory impairment, diminished mobility, and medication management. Recent developments in information technologies could improve the access to care for older people as well as reducing the need for full-time caregivers both in homes and institutions such as nursery homes and hospitals. This study aimed to review the economic evaluation of such technological advancements in the care of older people. Through a systematic approach, electronic databases were searched and of 2732 records retrieved, three papers were included in the final review. Three different models of economic evaluation including cost analysis, cost–benefit analysis and cost-effectiveness analysis were applied in these studies in the context of telemedicine and older persons' care. Since the methodological approaches were quite different and the outcomes reported were not consistent between studies, no meta-analysis was applicable and we qualitatively reviewed the papers. All studies have reported cost savings associated with the use of telemedicine technologies such as video visits and smart homes in the care of older persons.
Background: The integration of core packages of mental health care into routine primary health care has been introduced as an effective way to achieve universal health coverage in mental health care. Based on the transition of mental health care in Iran, from introducing basic mental health care in PHC to the experience of community-based mental health centers for urban areas, a new socio-mental health service model has been so far proposed. This study aimed to estimate the impact of scaling-up the new socio-mental health model at the national level as well as its associated costs.Methods: This study was a cost-consequence analysis following One Health Tool methodology. The data required for the study were collected in the first quarter of the year 2020 with a time horizon from 2020 to 2030. The selected metric for summarizing health effects is healthy life years gained. Resources used in terms of medicines, staff salaries and outpatient visits were documented and associated costs were subsequently estimated in order to estimate the average cost of each intervention per case. Results: The health impacts are calculated in terms of healthy life years gained, after adjusting the prevalence and incidence rates for each disorder. In total, 1,702,755 healthy life years were expected to be gained. Considering total 1,363,581,654 US dollars cost in basic scenario, each healthy life years gained will cost around 801 US dollars. Based on the WHO criteria for cost-effectiveness threshold, all of the values ranged from 724 to 1119 US dollars obtained through eight different scenarios were considered as cost-effective given the GDP per capita of 5,550 US dollars for Iran.Conclusions: Mental health budget in Iran equals to about three percent of total health expenditure while the mental health cost per capita is estimated to be 1.73 US dollar which are relatively low considering the share of the MNS disorders in the national burden of diseases. The results of current study showing the cost of 16.4 US dollar per capita for scaling up this comprehensive mental health service model can convince high-level policy-makers to increase the share of mental health budget accordingly.
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