1Hobart and Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania.
Aust N Z J Psychiatry. 2014 Mar;48(3):237-48. doi: 10.1177/0004867413508453. Epub 2013 Nov 12.
To assess differences in costs of psychosis between the first and second Australian national surveys of psychosis and examine them in light of policy developments.
Cost differences due to changes in resource use and/or real price rises were assessed by minimizing differences in recruitment and costing methodologies between the two surveys. For each survey, average annual societal costs of persons recruited through public specialized mental health services in the census month were assessed through prevalence-based, bottom-up cost-of-illness analyses. The first survey costing methodology was employed as the reference approach. Unit costs were specific to each time period (2000, 2010) and expressed in 2010 Australian dollars.
There was minimal change in the average annual costs of psychosis between the surveys, although newly included resources in the second survey's analysis cost AUD$3183 per person. Among resources common to each analysis were significant increases in the average annual cost per person for ambulatory care of AUD$7380, non-government services AUD$2488 and pharmaceuticals AUD$1892, and an upward trend in supported accommodation costs. These increases were offset by over a halving of mental health inpatient costs of AUD$11,790 per person and a 84.6% (AUD$604) decrease in crisis accommodation costs. Productivity losses, the greatest component cost, changed minimally, reflecting the magnitude and constancy of reduced employment levels of individuals with psychosis across the surveys.
Between 2000 and 2010 there was little change in total average annual costs of psychosis for individuals receiving treatment at public specialized mental health services. However, there was a significant redistribution of costs within and away from the health sector in line with government initiatives arising from the Second and Third National Mental Health Plans. Non-health sector costs are now a critical component of cost-of-illness analyses of mental illnesses reflecting, at least in part, a whole-of-government approach to care.
评估澳大利亚首次和第二次全国精神病学调查中精神疾病成本的差异，并根据政策发展情况进行分析。
通过最小化两次调查中招募和成本核算方法的差异，评估因资源使用变化和/或实际价格上涨而导致的成本差异。对于每个调查，通过基于患病率的成本效益分析，评估通过公共专门精神卫生服务招募的患者在普查月份的年度社会平均成本。采用首次调查的成本核算方法作为参考方法。单位成本特定于每个时间段（2000 年、2010 年），并以 2010 年澳元表示。
两次调查之间，精神疾病的平均年度成本变化很小，尽管第二次调查分析中新增的资源每人成本为 3183 澳元。在两次分析中都包含的资源中，门诊护理的人均年平均成本显著增加了 7380 澳元、非政府服务增加了 2488 澳元、药品增加了 1892 澳元，以及支持性住宿费用呈上升趋势。这些增加被每人心理健康住院费用减少 11790 澳元和危机住宿费用减少 84.6%（604 澳元）所抵消。生产力损失是最大的成本组成部分，变化不大，反映了两次调查中精神疾病患者就业水平降低的幅度和稳定性。
在 2000 年至 2010 年期间，在公共专门精神卫生服务接受治疗的个体的总平均年度精神疾病成本几乎没有变化。然而，根据第二和第三次国家心理健康计划带来的政府倡议，卫生部门内外的成本分配发生了重大变化。非卫生部门成本现在是精神疾病成本效益分析的关键组成部分，这至少反映了政府对护理的整体方法。
