Abstract
Background
The integration of core packages of mental health care into routine primary health care has been introduced as an effective way to achieve universal health coverage in mental health care. Based on the transition of mental health care in Iran, from introducing basic mental health care in PHC to the experience of community-based mental health centers for urban areas, a new socio-mental health service model has been so far proposed. This study aimed to estimate the impact of scaling-up the new socio-mental health model at the national level as well as its associated costs.
Methods
This study was an economic evaluation following One Health Tool methodology. The data required for the study were collected in the first quarter of the year 2020 with a time horizon from 2020 to 2030. The selected metric for summarizing health effects is healthy life years gained. Resources used in terms of drug and supply, staff salaries and outpatient visits were documented and associated costs were subsequently estimated in order to estimate the average cost of each intervention per case.
Results
The health impacts are calculated in terms of healthy life years gained for 2020-30, after adjusting the prevalence and incidence rates for each disorder. In total, 1,702,755 healthy life years were expected to be gained. Considering total 1,913,325,408 US dollars cost in base case scenario, each healthy life years gained will cost around 1124 US dollars. Based on the WHO criteria for cost-effectiveness threshold, all of the values ranged from 1042 to 1150 US dollars obtained through eight different scenarios were considered as cost-effective given the GDP per capita of 5506 US dollars for Iran in 2019.
Conclusions
The present study provided a timely analysis as the ministry of health in Iran sought to implement an ambitious plan of mental care scaling-up across the country. Therefore, this work could make a useful contribution to state-level deliberations on the implementation of this plan. Expanding such works beyond the mental health to all non-communicable diseases and making comparisons between packages of cares can be thus great evidence while the programs are aimed to be scaled-up.
Scaling up mental health care for refugee populations: a model by UNRWA
