Dlouhy Martin
Department of Econometrics, University of Economics, Prague, Czech Republic.
J Ment Health Policy Econ. 2004 Dec;7(4):159-65.
Although the mental health care is a substantial component of the health system in the Czech Republic, there is a lack of information and research on mental health expenditures. Determining the level and profile of mental health expenditures is the first step in achieving awareness of the cost of mental illness to society.
To describe the mental health care financing and delivery system in the Czech Republic and to estimate the mental health expenditures in 2001. The paper examines expenditures with regard to structure by type of service, relative share of total health expenditures, and relative share of the gross domestic product. It also makes international comparisons of mental health expenditures between the Czech Republic and other countries.
The data discussed in this study come from the Institute of Health Information and Statistics of the Czech Republic and from the General Health Insurance Fund of the Czech Republic. Mental health expenditures are defined as expenditures on services for patients with primary or first-listed diagnoses from Chapter V, Mental and Behavioural Disorders (F00-F99), of the Tenth Revision of International Classification of Diseases (ICD-10). Different methods of allocation are used for various types of services. In addition, expenditures of sickness insurance related to mental illness are also estimated.
Mental illness is diagnosed and treated in about 4% of the population. The share of mental illness on the total morbidity in the population is approximately 2%. The share of mental health expenditures on both the total health expenditures (3.54%) and the gross domestic product (0.26%) is low when compared to levels in other developed countries. Psychiatric hospitals consume 35.6% of mental health expenditures; prescribed drugs and medical aid consume 33.2%; specialized outpatient services consume 17.4%; and shares of other services are relatively low. IMPLICATIONS FOR HEALTH CARE POLICY FORMULATION: First, if the amount of expenditures allocated to mental health can be interpreted as an indicator of the government's commitment to mental health, then, in comparison to other developed countries, mental health has a low priority in the Czech Republic. Second, the improved availability of data on morbidity and regular analyses of these data are needed and should yield fast and valuable results.
尽管精神卫生保健是捷克共和国卫生系统的重要组成部分，但关于精神卫生支出的信息和研究却很匮乏。确定精神卫生支出的水平和概况是认识精神疾病对社会造成的成本的第一步。
描述捷克共和国的精神卫生保健筹资和提供系统，并估算2001年的精神卫生支出。本文按服务类型考察了支出结构、在卫生总支出中的相对份额以及在国内生产总值中的相对份额。还对捷克共和国与其他国家的精神卫生支出进行了国际比较。
本研究中讨论的数据来自捷克共和国卫生信息与统计研究所和捷克共和国健康保险总基金。精神卫生支出定义为用于患有国际疾病分类第十版（ICD - 10）第五章“精神和行为障碍”（F00 - F99）中主要或首要诊断的患者的服务支出。针对不同类型的服务采用了不同的分配方法。此外，还估算了与精神疾病相关的疾病保险支出。
约4%的人口被诊断患有精神疾病并接受治疗。精神疾病在总人口发病率中的占比约为2%。与其他发达国家相比，精神卫生支出在卫生总支出（3.54%）和国内生产总值（0.26%）中的占比很低。精神病医院消耗了35.6%的精神卫生支出；处方药和医疗救助消耗了33.2%；专科门诊服务消耗了17.4%；其他服务的占比相对较低。对卫生保健政策制定的启示：首先，如果分配给精神卫生的支出金额可被视为政府对精神卫生承诺的一个指标，那么与其他发达国家相比，精神卫生在捷克共和国的优先级较低。其次，需要提高发病率数据的可得性并对这些数据进行定期分析，且应能快速产生有价值的结果。
