BACKGROUND: Information about unit costs of psychiatric care is largely unavailable in Central and Eastern Europe, which poses an obstacle to economic evaluations as well as evidence-based development of the care in the region. OBJECTIVE: The objective of this study was to calculate the unit costs of inpatient and community mental health services in Czechia and to assess the current practices of data collection by mental healthcare providers. METHODS: We used bottom-up microcosting to calculate unit costs from detailed longitudinal accounts and records kept by three psychiatric hospitals and three community mental health providers. RESULTS: An inpatient day in a psychiatric hospital costs 1504 Czech koruna (CZK; €59), out of which 75% is consumed by hotel services and the rest by medication and therapies. The costed inpatient therapies include individual therapies provided by a psychiatrist or psychologist, consultations with a social worker, group therapies, organised cultural activities and training activities. As regards the community setting, we costed daycare social facilities, case management services, sheltered housing, supported housing, crisis help, social therapeutic workshops, individual placement and support, and self-help groups. CONCLUSIONS: The unit costs enable assigning financial value to individual items monitored by the Czech version of the Client Service Receipt Inventory, and thus estimation of costs associated with treatment of mental health problems. The employed methodology might serve as a guideline for the providers to improve data collection and to calculate costs of services themselves, with this information likely becoming more crucial for payers in the future.

Department of Psychiatry 1st Faculty of Medicine Charles University and General University Hospital Prague Ke Karlovu 11 181 120 00 Prague Czech Republic

Department of Public Mental Health National Institute of Mental Health Topolová 748 250 67 Klecany Czech Republic

Faculty of Informatics and Statistics University of Economics Prague W Churchill Sq 1938 4 130 67 Prague Czech Republic

Health Service and Population Research Department Institute of Psychiatry Psychology and Neuroscience David Goldberg Centre King's College London De Crespigny Park London SE5 8AF UK

Psychiatric Hospital Bohnice Ústavní 91 181 00 Prague Czech Republic

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Violence risk and personality assessment in adolescents by Structured Assessment of Violence Risk in Youth (SAVRY) and high school personality questionnaire (HSPQ): Focus on protective factors strengthening