Excess costs of alcohol-dependent patients in German psychiatric care compared with matched non-alcohol-dependent individuals from the general population: a secondary analysis of two datasets

Dams, Judith; Buchholz, Angela; Kraus, Ludwig; Reimer, Jens; Scherbaum, Norbert; Konnopka, Alexander; König, Hans‐Helmut

doi:10.1136/bmjopen-2017-020563

Cited by 7 publications

(10 citation statements)

References 37 publications

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“…However, studies examining an excess cost of MDs are less common. Excess cost provides an estimates of the cost difference between populations with and without mental health diagnosis adjusted for existing comorbidities and socio-economic characteristics [ 21 ]. Such information is crucial for priority setting and service planning across diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Such information is crucial for priority setting and service planning across diseases. Most of the existing studies examined the excess cost for individual mental health diagnoses, including schizophrenia or psychotic disorders [22][23][24][25], major or minor depression [26][27][28], anxiety disorders [29,30], alcohol dependence [21], and bipolar disorder [31,32]. Only a few studies looked at the excess cost of MDs overall in a general population sample, which is more relevant for health services organisation aspects considering that many services target MDs in general rather than one specific disorder.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…In this context, data are needed on excess healthcare costs associated with mental disorders for various purposes, such as conducting economic evaluations and measuring the burden [ 15 ]. To measure disease-specific burden, average costs should be disaggregated by the type of mental disorder and compared with those for similar populations without such disorders [ 15 – 18 ]. That is, there is a need to know not only the average cost but also the incremental cost in relation to the population without mental health diagnoses [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…To measure disease-specific burden, average costs should be disaggregated by the type of mental disorder and compared with those for similar populations without such disorders [ 15 – 18 ]. That is, there is a need to know not only the average cost but also the incremental cost in relation to the population without mental health diagnoses [ 17 , 18 ]. In this sense, if a new intervention can modify the costs or benefits in health associated to a given mental disorder, the burden of the new scenario proposed by the intervention can be obtained and compared with the current scenario in order to guide decision-making [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Excess healthcare costs of mental disorders in children, adolescents and young adults in the Basque population registry adjusted for socioeconomic status and sex

Larrañaga

Ibarrondo

Mar-Barrutia

et al. 2023

Cost Eff Resour Alloc

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Background Mental illnesses account for a considerable proportion of the global burden of disease. Economic evaluation of public policies and interventions aimed at mental health is crucial to inform decisions and improve the provision of healthcare services, but experts highlight that nowadays the cost implications of mental illness are not properly quantified. The objective was to measure the costs of excess use of all healthcare services by 1- to 30-year-olds in the Basque population as a function of whether or not they had a mental disorder diagnosis. Methods A real-world data study was used to identify diagnoses of mental disorders and to measure resource use in the Basque Health Service Registry in 2018. Diagnoses were aggregated into eight diagnostic clusters: anxiety, attention deficit hyperactivity disorder, conduct disorders, mood disorders, substance use, psychosis and personality disorders, eating disorders, and self-harm. We calculated the costs incurred by each individual by multiplying the resource use by the unit costs. Annual costs for each cluster were compared with those for individuals with no diagnosed mental disorders through entropy balancing and two-part models which adjusted for socioeconomic status (SES). Results Of the 609,381 individuals included, 96,671 (15.9%) had ≥ 1 mental disorder diagnosis. The annual cost per person was two-fold higher in the group diagnosed with mental disorders (€699.7) than that with no diagnoses (€274.6). For all clusters, annual excess costs associated with mental disorders were significant. The adjustment also evidenced a social gradient in healthcare costs, individuals with lower SES consuming more resources than those with medium and higher SES across all clusters. Nonetheless, the effect of being diagnosed with a mental disorder had a greater impact on the mean and excess costs than SES. Conclusions Results were consistent in showing that young people with mental disorders place a greater burden on healthcare services. Excess costs were higher for severe mental disorders like self-harm and psychoses, and lower SES individuals incurred, overall, more than twice the costs per person with no diagnoses. A socioeconomic gradient was notable, excess costs being higher in low SES individuals than those with a high-to-medium SES. Differences by sex were also statistically significant but their sizes were smaller than those related to SES.

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“…Moreover, the analysis of results and the relationship with the worker must respect confidentiality, cooperation, mutual commitment, and capacity building. The final goals are beneficial both for employers and employees and include the increase of workplace productivity by reducing absenteeism, presenteeism, and workplace accidents, as well as raising awareness of the toxic effects of psychoactive substances and their consequences in workers' performance by adopting a more healthily behavior during and outside working hours [9,11,12].…”

Section: Introductionmentioning

confidence: 99%

Abuse of Licit and Illicit Psychoactive Substances in the Workplace: Medical, Toxicological, and Forensic Aspects

Dinis-Oliveira

Magalhães

2020

JCM

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About one-third of adult life is spent in the workplace. The use of psychoactive substances is a major preventable cause of morbidity and mortality. The consumption of psychoactive substances during or outside working hours greatly increases the frequency and severity of labor accidents, as well as the workers’ poor general state of health and productivity, implying higher costs for enterprises. It is the responsibility of organizations to ensure the safety and health of their workers. These cannot be limited to traditional routine clinical exams, as other aspects also have an impact on health. Thus, prevention and intervention in the consumption of psychoactive substances (e.g., ethanol, opioids, central nervous system stimulants or depressants, hallucinogens, Cannabis derivatives, dissociative substances, and inhalants) in labor activity should be considered as an investment of organizations and not as a cost, in view of the professional, personal, and family advantages for workers and employers, with a potential impact on productivity, security, health, and quality of life at work. Despite the extensive literature on the subject, each article generally focuses on one or another aspect of a very specific nature, not tackling the problem in a holistic way by confronting clinical, safety, and legal issues. This article presents a reflection on the legal, laboratorial, clinical, ethical, forensic, and safety concerns related to the consumption of psychoactive substances in the workplace, and can be a cross-cutting contribution to occupational medicine, forensic medicine, and insurance medicine, as well as for entrepreneurs, lawyers, judges, workers, and technicians from the public and private sectors that develop projects in this area. This discussion is based on general principles established internationally and highlights the role of the occupational healthcare system and other decision-making actors in the prevention and supervision of workplace psychoactive consumption.

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Excess costs of alcohol-dependent patients in German psychiatric care compared with matched non-alcohol-dependent individuals from the general population: a secondary analysis of two datasets

Cited by 7 publications

References 37 publications

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

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

Excess healthcare costs of mental disorders in children, adolescents and young adults in the Basque population registry adjusted for socioeconomic status and sex

Abuse of Licit and Illicit Psychoactive Substances in the Workplace: Medical, Toxicological, and Forensic Aspects

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