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The British Journal of Psychiatry (2003) 183: 220-225
© 2003 The Royal College of Psychiatrists

Variations in the costs of child and adolescent psychiatric in-patient units{dagger}

JENNIFER BEECHAM, PhD and DANIEL CHISHOLM, PhD

Centre for the Economics of Mental Health (CEMH), Health Services Research Department, Institute of Psychiatry, London, UK

ANNE O’HERLIHY, BSc

The Royal College of Psychiatrists’ Research Unit, London

JACK ASTIN, MSc

Centre for the Economics of Mental Health (CEMH), Health Services Research Department, Institute of Psychiatry, London, UK

Correspondence: Dr Jennifer Beecham; Centre for the Economics of Mental Health (CEMH), Box No. P024, The David Goldberg Centre, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. E-mail: J.Beecham{at}iop.kcl.ac.uk

Declaration of interest The Department of Health funded the study. There were no competing interests.

{dagger} See invited commentary, pp. 226–227, this issue.

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.

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

Method Data collection alongside a national survey with cost estimations guided byprinciples 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=£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.


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