Non-mental health hospital costs associated with selected serious mental health conditions in Europe

Abstract Introduction Individuals with mental health conditions (MHCs) have more physical health problems compared to the general population, which incur excess non-mental healthcare costs. The magnitude of excess costs is largest in the hospital care sector, but has not been comprehensively assessed in Europe. The aim of this study was to estimate total and excess hospital costs of physical health disparities in selected serious MHCs in Europe. Methods We modelled non-mental health inpatient and emergency care costs associated with excess physical health burden of alcohol use disorders (AUD), bipolar disorder (BD), depressive disorders (DD), and schizophrenia (SZ) across 312.5 million working-age individuals in 32 European countries in purchasing power standard Euros (PPS€). We obtained input data from the European Statistical Agency and recently published epidemiological and health economic syntheses. Results Aggregated annual non-mental health hospital costs were 20.3 billion PPS€ for AUD, 6.7 billion PPS€ for BD, 26.5 billion PPS€ for DD and 1.8 billion PPS€ for SZ. Their excess proportions equalled 59% for AUD, 57% for BD, 53% for DD, and 36% for SZ. Reducing the excess physical health burden by 1% could amount to potential annual savings in non-mental health hospital costs of serious MHCs of more than 190 million PPS€ in Europe. Discussion This study is the first to provide comprehensive European estimates of the hospital costs associated with the excess physical health burden of MHCs, reflecting 1.8% of the included countries’ total healthcare expenditure or 0.16% of their gross domestic product. Investments in better prevention, diagnosis, access, and integrated care approaches may alleviate physical health disparities while achieving potential additional savings. Schizophrenia results reflect comparative underutilisation due to underdiagnosis of physical ill health. Key messages • Physical health disparities in mental health conditions are linked to substantial excess hospital costs of inpatient and emergency care across Europe. • Investing in improved prevention, care access, and integrated care approaches may alleviate disparities while achieving cost savings.