Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
The European Journal of Health Economics
Published in: The European Journal of Health Economics 7/2020

Open Access 01-09-2020 | Original Paper

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

Authors: Agata Łaszewska, Johannes Wancata, Rebecca Jahn, Judit Simon

Published in: The European Journal of Health Economics | Issue 7/2020

Login to get access

Abstract

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.
Appendix
Available only for authorised users
Literature
1.
2.
Wittchen, H.U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jonsson, B., Olesen, J., Allgulander, C., Alonso, J., Faravelli, C., Fratiglioni, L., Jennum, P., Lieb, R., Maercker, A., van Os, J., Preisig, M., Salvador-Carulla, L., Simon, R., Steinhausen, H.C.: The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur. Neuropsychopharmacol. 21(9), 655–679 (2011)PubMedCrossRef
3.
Beecham, J., Knapp, M.: Costing psychiatric interventions. In: Thornicroft, G. (ed.) Measuring mental health needs (second edition), pp. 200–224. Royal College of Psychiatrists, London (2001)
4.
Andlin-Sobocki, P., Jonsson, B., Wittchen, H.U., Olesen, J.: Cost of disorders of the brain in Europe. Eur. J. Neurol. 12(Suppl 1), 1–27 (2005)PubMedCrossRef
5.
Wancata, J., Sobocki, P., Katschnig, H.: Cost of disorders of the brain in Austria in the year 2004. Wien. Klin. Wochenschr. 119(3–4), 91–98 (2007)PubMedCrossRef
6.
Gustavsson, A., Svensson, M., Jacobi, F., Allgulander, C., Alonso, J., Beghi, E., Dodel, R., Ekman, M., Faravelli, C., Fratiglioni, L.: Cost of disorders of the brain in Europe 2010. Eur. Neuropsychopharmacol. 21(10), 718–779 (2011)PubMedCrossRef
7.
Sobocki, P., Jönsson, B., Angst, J., Rehnberg, C.: Cost of depression in Europe. J. Ment. Health Policy Econ. 9(2), 87–98 (2006)PubMed
8.
Bachner, F., Bobek, J., Habimana, K., Ladurner, J., Lepuschütz, L., Ostermann, H., Rainer, L., Schmidt, A.E., Zuba, M., Quentin, W., Winkelmann, J.: Austria: Health system review. Health Syst. Transit. 20(3), 1–256 (2018)PubMed
9.
10.
11.
12.
ÖBIG: Psychiatrische und psychotherapeutische Versorgung 2007. Geschäftsbereich ÖBIG, Vienna (2010)
13.
Zechmeister, I., Oesterle, A.: Distributional impacts of mental health care financing arrangements: a comparison of the UK, Germany and Austria. J. Ment. Health Policy Econ. 9(1), 35–44 (2006)PubMed
14.
Simon, G.E.: Social and economic burden of mood disorders. Biol. Psychiatry 54(3), 208–215 (2003)PubMedCrossRef
15.
Rice, D.P.: Economic burden of mental disorders in the United States. TEN 1(2), 40–44 (1999)
16.
Stephens, T., Joubert, N.: The economic burden of mental health problems in Canada. Chronic Dis. Can. 22(1), 18–23 (2001)PubMed
17.
Tiainen, A., Rehnberg, C.: The economic burden of psychiatric disorders in Sweden. Int. J. Soc. Psychiatry 56(5), 515–526 (2010)PubMedCrossRef
18.
Xu, J., Wang, J., Wimo, A., Qiu, C.: The economic burden of mental disorders in China, 2005–2013: implications for health policy. BMC Psychiatry 16, 137 (2016)PubMedPubMedCentralCrossRef
19.
McCallum, S.M., Batterham, P.J., Calear, A.L., Sunderland, M., Carragher, N.: Reductions in quality of life and increased economic burden associated with mental disorders in an Australian adult sample. Aust. Health Rev. 43(6), 644–652 (2019)PubMedCrossRef
20.
Oliva-Moreno, J., López-Bastida, J., Montejo-González, A.L., Osuna-Guerrero, R., Duque-González, B.: The socioeconomic costs of mental illness in Spain. Eur. J. Health Econ. 10(4), 361–369 (2009)PubMedCrossRef
21.
Dams, J., Buchholz, A., Kraus, L., Reimer, J., Scherbaum, N., Konnopka, A., Konig, H.H.: 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. BMJ Open 8(8), e020563 (2018)PubMedPubMedCentralCrossRef
22.
de Oliveira, C., Cheng, J., Rehm, J., Kurdyak, P.: The economic burden of chronic psychotic disorders in Ontario. J. Ment. Health Policy Econ. 19(4), 181–192 (2016)PubMed
23.
Cloutier, M., Aigbogun, M.S., Guerin, A., Nitulescu, R., Ramanakumar, A.V., Kamat, S.A., DeLucia, M., Duffy, R., Legacy, S.N., Henderson, C., Francois, C., Wu, E.: The economic burden of schizophrenia in the United States in 2013. J. Clin. Psychiatry 77(6), 764–771 (2016)PubMedCrossRef
24.
Frey, S.: The economic burden of schizophrenia in Germany: a population-based retrospective cohort study using genetic matching. Eur. Psychiatry 29(8), 479–489 (2014)PubMedCrossRef
25.
Wu, E.Q., Birnbaum, H.G., Shi, L., Ball, D.E., Kessler, R.C., Moulis, M., Aggarwal, J.: The economic burden of schizophrenia in the United States in 2002. J. Clin. Psychiatry 66(9), 1122–1129 (2005)PubMedCrossRef
26.
Chiu, M., Lebenbaum, M., Cheng, J., de Oliveira, C., Kurdyak, P.: The direct healthcare costs associated with psychological distress and major depression: a population-based cohort study in Ontario, Canada. PLoS ONE 12(9), e0184268 (2017)PubMedPubMedCentralCrossRef
27.
Greenberg, P.E., Fournier, A.A., Sisitsky, T., Pike, C.T., Kessler, R.C.: The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J. Clin. Psychiatry 76(2), 155–162 (2015)PubMedCrossRef
28.
Cuijpers, P., Smit, F., Oostenbrink, J., De Graaf, R., Ten Have, M., Beekman, A.: Economic costs of minor depression: a population-based study. Acta Psychiatr. Scand. 115(3), 229–236 (2007)PubMedCrossRef
29.
Dams, J., König, H.-H., Bleibler, F., Hoyer, J., Wiltink, J., Beutel, M.E., Salzer, S., Herpertz, S., Willutzki, U., Strauß, B.: Excess costs of social anxiety disorder in Germany. J. Affect. Disord. 213, 23–29 (2017)PubMedCrossRef
30.
Acarturk, C., Smit, F., De Graaf, R., Van Straten, A., Ten Have, M., Cuijpers, P.: Economic costs of social phobia: a population-based study. J. Affect. Disord. 115(3), 421–429 (2009)PubMedCrossRef
31.
Cloutier, M., Greene, M., Guerin, A., Touya, M., Wu, E.: The economic burden of bipolar I disorder in the United States in 2015. J. Affect. Disord. 226, 45–51 (2018)PubMedCrossRef
32.
Fisher, L.J., Goldney, R.D., Dal Grande, E., Taylor, A.W., Hawthorne, G.: Bipolar disorders in Australia. A population-based study of excess costs. Soc. Psychiatry Psychiatr. Epidemiol. 42(2), 105–109 (2007)PubMedCrossRef
33.
Smit, F., Cuijpers, P., Oostenbrink, J., Batelaan, N., de Graaf, R., Beekman, A.: Costs of nine common mental disorders: implications for curative and preventive psychiatry. J. Ment. Health Policy Econ. 9(4), 193–200 (2006)PubMed
34.
Alexandrowicz, R.W., Bacher, J., Wancata, J.: Sampling and weighting of the Austrian Psychiatric Prevalence Survey (APPS). Neuropsychiatry 33(2), 90–97 (2019)CrossRef
35.
Wing, J.K., Babor, T., Brugha, T., Burke, J., Cooper, J., Giel, R., Jablenski, A., Regier, D., Sartorius, N.: Scan: schedules for clinical assessment in neuropsychiatry. Arch. Gen. Psychiatry 47(6), 589–593 (1990)PubMedCrossRef
36.
World Health Organization: Schedules for clinical assessment in neuropsychiatry, version 2.1. Geneva: World Health Organization, Division of Mental Health (1998)
37.
Aboraya, A., Tien, A., Stevenson, J., Crosby, K.: Schedules for clinical assessment in neuropsychiatry (SCAN): introduction to WV's mental health community. W. V. Med. J. 94(6), 326–328 (1998)PubMed
38.
World Health Organization: International statistical classification of diseases and related health problems, 10th revision (ICD-10). WHO, Geneva (1992)
39.
Zechmeister, I., Loibl, T.: Eltern-Kind-Vorsorge neu. Teil III: Ist-Erhebung der Finanzierungs-und Kostenstrukturen von Eltern-Kind Leistungen in Österreich. Ludwig Boltzmann Institut für Health Technology Assessment, Wien (2011)
40.
41.
42.
Hofmarcher, M., Quentin, W.: Austria: health system review. Health Syst. Transit. 15(7), 1–291 (2013)PubMed
43.
44.
45.
Drummond, M.F., Sculpher, M.J., Claxton, K., Stoddart, G.L., Torrance, G.W.: Methods for the economic evaluation of health care programmes, 4th edn. Oxford University Press, Oxford (2015)
46.
Neumann, P.J., Sanders, G.D., Russell, L.B., Siegel, J.E., Ganiats, T.G.: Cost-effectiveness in health and medicine, 2nd edn. Oxford University Press, Oxford (2017)
47.
48.
Friemel, S., Bernert, S., Angermeyer, M.C., König, H.-H.: Die direkten Kosten von depressiven Erkrankungen in Deutschland. Psychiatr. Prax. 32(03), 113–121 (2005)PubMedCrossRef
49.
50.
Larg, A., Moss, J.R.: Cost-of-illness studies: a guide to critical evaluation. Pharmacoeconomics 29(8), 653–671 (2011)PubMedCrossRef
51.
Manning, W.G., Mullahy, J.: Estimating log models: to transform or not to transform? J. Health Econ. 20(4), 461–494 (2001)PubMedCrossRef
52.
Box, G.E., Cox, D.R.: An analysis of transformations. J. R. Stat. Soc Ser. B Stat. Methodol. 26(2), 211–243 (1964)
53.
Stubbs, B., Vancampfort, D., Hallgren, M., Firth, J., Veronese, N., Solmi, M., Brand, S., Cordes, J., Malchow, B., Gerber, M., Schmitt, A., Correll, C.U., De Hert, M., Gaughran, F., Schneider, F., Kinnafick, F., Falkai, P., Moller, H.J., Kahl, K.G.: EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH). Eur. Psychiatry 54, 124–144 (2018)PubMedCrossRef
54.
De Hert, M., Correll, C.U., Bobes, J., Cetkovich-Bakmas, M., Cohen, D., Asai, I., Detraux, J., Gautam, S., Möller, H.-J., Ndetei, D.M., Newcomer, J.W., Uwakwe, R., Leucht, S.: Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 10(1), 52–77 (2011)CrossRef
55.
Druss, B.G., Ji, X., Glick, G., von Esenwein, S.A.: Randomized trial of an electronic personal health record for patients with serious mental illnesses. Am. J. Psychiatry 171(3), 360–368 (2014)PubMedCrossRef
56.
StataCorp: Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC (2017)
57.
58.
59.
Schneider, U., Linder, R., Verheyen, F.: Long-term sick leave and the impact of a graded return-to-work program: evidence from Germany. Eur. J. Health Econ. 17(5), 629–643 (2016)PubMedCrossRef
60.
Mikkelsen, M.B., Rosholm, M.: Systematic review and meta-analysis of interventions aimed at enhancing return to work for sick-listed workers with common mental disorders, stress-related disorders, somatoform disorders and personality disorders. Occup. Environ. Med. 75(9), 675–686 (2018)PubMedCrossRef
61.
Rizzo, J.A., Chen, J., Gunnarsson, C.L., Naim, A., Lofland, J.H.: Adjusting for comorbidities in cost of illness studies. J. Med. Econ. 18(1), 12–28 (2015)PubMedCrossRef
62.
63.
Polder, J.J., Meerding, W.J., Bonneux, L., van der Maas, P.J.: A cross-national perspective on cost of illness: a comparison of studies from The Netherlands, Australia, Canada, Germany, United Kingdom, and Sweden. Eur. J. Health Econ. 6(3), 223–232 (2005)PubMedCrossRef
64.
Hoffmann, K., Stein, K.V., Maier, M., Rieder, A., Dorner, T.E.: Access points to the different levels of health care and demographic predictors in a country without a gatekeeping system. Results of a cross-sectional study from Austria. Eur. J. Public Health 23(6), 933–939 (2013)PubMedCrossRef
65.
Wang, P.S., Lane, M., Olfson, M., Pincus, H.A., Wells, K.B., Kessler, R.C.: Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch. Gen. Psychiatry 62(6), 629–640 (2005)PubMedCrossRef
66.
Sun, Y., Moller, J., Lundin, A., Wong, S.Y.S., Yip, B.H.K., Forsell, Y.: Utilization of psychiatric care and antidepressants among people with different severity of depression: a population-based cohort study in Stockholm, Sweden. Soc. Psychiatry Psychiatr. Epidemiol. 53(6), 607–615 (2018)PubMedPubMedCentralCrossRef
67.
Bijl, R.V., Ravelli, A.: Psychiatric morbidity, service use, and need for care in the general population: results of The Netherlands Mental Health Survey and Incidence Study. Am. J. Public Health 90(4), 602–607 (2000)PubMedPubMedCentralCrossRef
68.
Burgess, P.M., Pirkis, J.E., Slade, T.N., Johnston, A.K., Meadows, G.N., Gunn, J.M.: Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust. N. Z. J. Psychiatry 43(7), 615–623 (2009)PubMedCrossRef
69.
Fleury, M.J., Grenier, G., Bamvita, J.M., Perreault, M., Kestens, Y., Caron, J.: Comprehensive determinants of health service utilisation for mental health reasons in a Canadian catchment area. Int. J. Equity Health 11, 20 (2012)PubMedPubMedCentralCrossRef
70.
Greenberg, P.E., Kessler, R.C., Birnbaum, H.G., Leong, S.A., Lowe, S.W., Berglund, P.A., Corey-Lisle, P.K.: The economic burden of depression in the United States: how did it change between 1990 and 2000? J. Clin. Psychiatry 64(12), 1465–1475 (2003)PubMedCrossRef
71.
Sobocki, P., Ekman, M., Agren, H., Krakau, I., Runeson, B., Martensson, B., Jonsson, B.: Resource use and costs associated with patients treated for depression in primary care. Eur. J. Health Econ. 8(1), 67–76 (2007)PubMedCrossRef
72.
Fazel, S., Khosla, V., Doll, H., Geddes, J.: The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis. PLoS Med. 5(12), e225–e225 (2008)PubMedPubMedCentralCrossRef
73.
Blaauw, E., Roesch, R., Kerkhof, A.: Mental disorders in European prison systems. Arrangements for mentally disordered prisoners in the prison systems of 13 European countries. Int. J. Law Psychiatry 23(5–6), 649–663 (2000)PubMedCrossRef
74.
Volkert, J., Schulz, H., Harter, M., Wlodarczyk, O., Andreas, S.: The prevalence of mental disorders in older people in Western countries—a meta-analysis. Ageing Res Rev 12(1), 339–353 (2013)PubMedCrossRef
75.
Łaszewska, A., Österle, A., Wancata, J., Simon, J.: Prevalence of mental diseases in Austria: Systematic review of the published evidence. Wien. Klin. Wochenschr. 130(3), 141–150 (2018)PubMedPubMedCentralCrossRef
76.
Metadata
Title
The excess economic burden of mental disorders: findings from a cross-sectional prevalence survey in Austria
Authors
Agata Łaszewska
Johannes Wancata
Rebecca Jahn
Judit Simon
Publication date
01-09-2020
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 7/2020
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-020-01200-0

Other articles of this Issue 7/2020

The European Journal of Health Economics 7/2020 Go to the issue

Editorial

Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19

Original Paper

Cost-effectiveness of biennial screening for diabetes related retinopathy in people with type 1 and type 2 diabetes compared to annual screening

Original Paper

Patterns of care and cost profiles of women with breast cancer in Italy: EPICOST study based on real world data

Original Paper

Impacts of air pollution on health: evidence from longitudinal cohort data of patients with cardiovascular diseases

Original Paper

Discrete choice experiments to generate utility values for multi-attribute utility instruments: a systematic review of methods

Original Paper

Modeling Personalized Adjuvant TreaTment in EaRly stage coloN cancer (PATTERN)