Objective: Hospitalization is a critical component of treatment for people with serious and persistent mental illness. Despite their resource intensity, the costs of inpatient psychiatric hospitalizations in the United States are not well understood. The objective of this research was to provide cost estimates for inpatient psychiatric care.
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Methods: Using the premier perspective comparative database, supplemented by the marketscan database, this study estimated average charges, cost of providing care, and amount of reimbursement for inpatient psychiatric care at 418 community hospitals. in 2006 (n=261,996 hospitalizations).
Findings: Charges were 2.5 times higher than hospitals’ reported costs for providing care. the amounts reimbursed indicated by marketcan were similar to the costs reported to provide care. The average cost to provide care was highest for Medicare and lowest for the uninsured: schizophrenia treatment, $8,509 for 11.1 days and $5,707 for 7.4 days, respectively; bipolar disorder treatment, $7,593 for 9.4 days and $4,356 for 5.5 days; depression treatment, $6,990 for 8.4 days and $3,616 for 4.4 days; drug use disorder treatment, $4,591 for 5.2 days and $3,422 for 3.7 days; and alcohol use disorder treatment, $5,908 for 6.2 days and $4,147 for 3.8 days.
Conclusions: Consistent with previous research, the results suggest that previous attempts to control prices may have had unintended consequences, including a large gap between charges and amounts reimbursed, the possible cost shifting between payers and potentially extended lengths of stay to compensate for reduced per diems. the lack of transparency in prices makes it difficult to estimate the cost to society of a day of psychiatric hospitalization.