Variations in the costs of child and adolescent psychiatric in-patient units.
BACKGROUND
Child and adolescent in-patient care is a highly specialised service, ideally requiring planning at a national level, but there are no routine data collections specifically for these services.


OBJECTIVE
To estimate unit costs for child and adolescent psychiatric in-patient units and to analyse the variations in costs between units.


METHODS
Data collection alongside a national survey with cost estimations guided by principles drawn from economic theory. Bivariate and multivariate analyses are employed to identify cost influences.


RESULTS
Fifty-eight units could provide sufficient data to allow calculation of the cost per in-patient day; mean= pound 197 (s.d.=71.6; 1999-2000 prices). The management sector, type of provision, number of rooms, capacity and location explained nearly half of the cost variation.


CONCLUSIONS
Child and adolescent psychiatric in-patient units are an expensive resource, with personnel absorbing two-thirds of the total costs. Costs per in-patient day vary fourfold and the exploration of cost variations can inform commissioning strategies.
Beecham
Jennifer
J
Centre for the Economics of Mental Health (CEMH), Health Services Research Department, Institute of Psychiatry, London, UK. J.Beecham@iop.kcl.ac.uk
Chisholm
Daniel
D
O'Herlihy
Anne
A
Astin
Jack
J
D000293:Adolescent; D002648:Child; D003365:Costs and Cost Analysis / Q000191:economics / Q000379:methods; D004739:England; D006282:Health Personnel / Q000191:economics; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy; D008605:Mental Health Services / Q000191:economics*; D012456:Salaries and Fringe Benefits / Q000191:economics; D014852:Wales