Article Abstract Online ISSN: 1099-176X    Print ISSN: 1091-4358 The Journal of Mental Health Policy and Economics Volume 7, Issue 4, 2004. Pages: 159-165 Published Online: 13 Dec 2004 Copyright © 2004 ICMPE.

* Correspondence to: Martin Dlouhy, University of Economics, Department of Econometrics, W. Churchill Sq. 4, 13067 Prague 3, Czech Republic.
Tel.: +420-2-2409 5448
Fax:  +420-2-2409 5423
E-mail: dlouhy@vse.cz

Source of Funding: This project was supported by NIH Research Grant # D43 TW05810, funded by the Fogarty International Center, and the National Institute of Mental Health.

Abstract

This study describes the mental health care financing and delivery system in the Czech Republic and estimates the mental health expenditures in 2001. It examines mental health expenditures with regard to structure by type of service, relative share of total health expenditures, and relative share of the gross domestic product. Mental illness is diagnosed and treated in about 4% of the population. The share of mental illness on the total morbidity in the population is approximately 2%. The share of mental health expenditures on both the total health expenditures (3.54%) and the gross domestic product (0.26%) is low when compared to levels in other developed countries. Psychiatric hospitals consume 35.6% of mental health expenditures; prescribed drugs and medical aid consume 33.2%; specialized outpatient services consume 17.4%; and shares of other services are relatively low.

Background: Although the mental health care is a substantial component of the health system in the Czech Republic, there is a lack of information and research on mental health expenditures. Determining the level and profile of mental health expenditures is the first step in achieving awareness of the cost of mental illness to society. Aims of the Study: To describe the mental health care financing and delivery system in the Czech Republic and to estimate the mental health expenditures in 2001. The paper examines expenditures with regard to structure by type of service, relative share of total health expenditures, and relative share of the gross domestic product. It also makes international comparisons of mental health expenditures between the Czech Republic and other countries. Methods: The data discussed in this study come from the Institute of Health Information and Statistics of the Czech Republic and from the General Health Insurance Fund of the Czech Republic. Mental health expenditures are defined as expenditures on services for patients with primary or first-listed diagnoses from Chapter V, Mental and Behavioural Disorders (F00-F99), of the Tenth Revision of International Classification of Diseases (ICD-10). Different methods of allocation are used for various types of services. In addition, expenditures of sickness insurance related to mental illness are also estimated. Results: Mental illness is diagnosed and treated in about 4% of the population. The share of mental illness on the total morbidity in the population is approximately 2%. The share of mental health expenditures on both the total health expenditures (3.54%) and the gross domestic product (0.26%) is low when compared to levels in other developed countries. Psychiatric hospitals consume 35.6% of mental health expenditures; prescribed drugs and medical aid consume 33.2%; specialized outpatient services consume 17.4%; and shares of other services are relatively low. Implications for Health Care Policy Formulation: First, if the amount of expenditures allocated to mental health can be interpreted as an indicator of the government's commitment to mental health, then, in comparison to other developed countries, mental health has a low priority in the Czech Republic. Second, the improved availability of data on morbidity and regular analyses of these data are needed and should yield fast and valuable results.

Received 18 May 2004; accepted 26 October 2004

Copyright © 2004 ICMPE