Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria.
Department of Health Economics and Health Services Research, University Medical Center Hamburg, 20246 Hamburg, Germany.
Int J Environ Res Public Health. 2022 Mar 16;19(6):3500. doi: 10.3390/ijerph19063500.
Improving the efficiency of mental healthcare service delivery by learning from international best-practice examples requires valid data, including robust unit costs, which currently often lack cross-country comparability. The European ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) aimed to harmonize the international unit cost development. This article presents the methodology and set of 36 externally validated, standardized reference unit costs (RUCs) for five health and social care services (general practitioner, dentist, help-line, day-care center, nursing home) in Austria, England, Germany, Hungary, The Netherlands, and Spain based on unambiguous service definitions using the extended DESDE PECUNIA coding framework. The resulting PECUNIA RUCs are largely comparable across countries, with any causes for deviations (e.g., country-specific scope of services) transparently documented. Even under standardized methods, notable limitations due to data-driven divergences in key costing parameters remain. Increased cross-country comparability by adopting a uniform methodology and definitions can advance the quality of evidence-based policy guidance derived from health economic evaluations. The PECUNIA RUCs are available free of charge and aim to significantly improve the quality and feasibility of future economic evaluations and their transferability across mental health systems.
从国际最佳实践中学习以提高精神卫生保健服务的效率需要有效的数据，包括可靠的单位成本，而目前这些数据往往缺乏跨国可比性。欧洲成本核算、资源使用衡量和多部门国家和国际卫生经济评估中的结果估值方案（PECUNIA）旨在协调国际单位成本的发展。本文介绍了在使用扩展的 DESDE PECUNIA 编码框架基于明确的服务定义的情况下，针对奥地利、英国、德国、匈牙利、荷兰和西班牙的五种卫生和社会保健服务（全科医生、牙医、求助热线、日托中心、养老院）制定的方法和 36 种经过外部验证的标准化参考单位成本（RUC）。根据明确的服务定义，得出的 PECUNIA RUC 在很大程度上在各国之间具有可比性，任何偏差的原因（例如，特定国家的服务范围）都有明确的记录。即使采用标准化方法，由于关键成本参数的数据驱动差异，仍存在明显的局限性。通过采用统一的方法和定义来提高跨国可比性，可以提高基于健康经济评估的循证政策指导的质量。PECUNIA RUC 免费提供，旨在显著提高未来经济评估的质量和可行性，并提高其在精神卫生系统中的可转移性。
