Issues in estimating the cost of innovative mental health programs
- 54 Downloads
This paper reviews problems encountered in estimating the unit cost of services provided by innovative mental health programs and illustrates methods for addressing these problems. Generally, the cost of a health care service is determined by identifying all resources used in its production and the cost of those resources. These costs are divided by appropriate workload measures to determine the cost per unit of service or per client. Issues that must be addressed include: 1) direct program costs; 2) indirect costs (including administration and capital costs); 3) program resources used to support research and othernonprogram activities; and 4) identification of “typical” workloads as the program is implemented. Application of these methods is illustrated with data from a multi-site study of intensive psychiatric community care conducted at nine Department of Veterans Affairs Medical Centers in the Northeast. A sensitivity analysis revealed that estimates of program costs vary by 59% over the entire program, and from 17%–168% at individual sites, depending on which cost estimation methods were included. The average cost of case management in this program varied considerably across sites, primarily reflecting differences in caseload size and staffing levels. Adjusting for inflation, the cost of this program falls below the cost of other published intensive community programs.
Unable to display preview. Download preview PDF.
- 2.Fenton FR, Tessier L, Contandriopoulis A-P, Nguyen H, and Streuning EL: A Comparative Trial of Home and Hospital Psychiatric Treatment. Financial Costs 27:177–187, 1982.Google Scholar
- 4.Rosenheck RA, Frisman LK and Neale MS: Estimating the Capital Component of Health Care Costs in the Public Sector (Administration and Policy in Mental Health), 21: 493–509, 1994.Google Scholar
- 8.Anthony W, Cohen M, and Farkas M: Psychiatric Rehabilitation, Boston, University, Boston, MA, 1991.Google Scholar
- 10.US Bureau of the Census: Statistical Abstracts of the United States: 1990 (110th edition) Washington, DC, 1990.Google Scholar