Expenditures on mental health care in the Czech Republic are not being published regularly, yet they are indispensable for evaluation of the ongoing reform of Czech mental health care. The main objective of this study is to estimate the size of these expenditures in 2015 and make a comparison with the last available figures from the year 2006. The estimation is based on an OECD methodology of health accounts, which structures health care expenditures according to health care functions, provider industries, and payers. The expenditures are further decomposed according to diagnoses, and inputs used in service production. The amount spent on mental health care in 2015 reached more than 13.7 billion Czech korunas (EUR 501.6 million), which represented 4.08% of the total health care expenditures. This ratio is almost identical with the 2006 share (4.14%). There are no significant changes in the relative expenditures on mental health care and in the structure of service provision. The Czech mental health care system remains largely hospital based with most of all mental health care expenditures being spent on inpatient care. Future developments in the expenditures will indicate the success of the current effort to deinstitutionalise mental health care.

• Keywords
• Central and Eastern Europe, Deinstitutionalization, Expenditures on psychiatric care, Mental health care reform, OECD system of health accounts,
• MeSH
• Mental Disorders economics   therapy   MeSH
• Hospitalization economics   MeSH
• Humans MeSH
• Mental Health Services economics   MeSH
• Health Expenditures statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

BACKGROUND: Policy makers as well as health services researchers lack information on financial flows within national mental health systems. The studies that are available use different methodologies and hence it is difficult to make any comparisons. The aim of this study was to modify the existing health accounting framework and apply it to describe and analyse the financial flows within a national mental health system. METHODS: Mental health expenditures are classified by the three-dimensional methodology of OECD health accounts that is extended by two other dimensions for the purpose of the study. RESULTS: The framework of five-dimensional mental health accounts is introduced and applied to mental health expenditure in the Czech Republic, 2006. Mental health expenditure is estimated to be 4.14% of the total health expenditure. Mental health expenditure is classified based on its source of financing, provider industry, health-care function, cost category and diagnostic group. CONCLUSIONS: Health expenditure estimates present the most detailed information on resource allocation in the mental health system of the Czech Republic. The application of the standardized framework in other countries can improve the quality of international comparisons. On the national level, especially if the time series are available, mental health accounts can serve as a useful tool for strategic resource allocation decisions. This is particularly useful for the countries that plan changes in resource allocation directed from institutional to community-based care.

• MeSH
• Health Services Accessibility MeSH
• Mental Disorders economics   epidemiology   MeSH
• Financing, Government statistics & numerical data   MeSH
• Humans MeSH
• Health Care Costs statistics & numerical data   MeSH
• National Health Programs economics   MeSH
• Managed Competition statistics & numerical data   MeSH
• Mental Health Services economics   supply & distribution   MeSH
• Health Expenditures statistics & numerical data   MeSH
• Health Services Research MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Research Support, N.I.H., Extramural MeSH
• Geographicals
• Czech Republic epidemiology   MeSH