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. This study was a cost-consequence analysis 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. The health impacts are calculated in terms of healthy life years gained for 2020–2030, 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 1,363,581,654 US dollars cost in base case scenario, each healthy life years gained will cost around 801 US dollars. Based on the WHO criteria for cost-effectiveness threshold, all of the values ranged from 724 to 1119 US dollars obtained through eight different scenarios were considered as cost-effective given the GDP per capita of 5550 US dollars for Iran in 2018. Mental health budget in Iran equals to about three percent of total health expenditure while the mental health cost per capita is estimated to be 1.73 US dollar which are relatively low considering the share of the MNS disorders in the national burden of diseases. The results of current study showing the cost of 16.4 US dollar per capita for scaling up this comprehensive mental health service model can convince high-level policy-makers to increase the share of mental health budget accordingly. The present study demonstrated that the cost in this new socio-mental services model is not substantial compared with GDP per capita of Iran.

中文翻译：

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经济评估研究：扩大伊朗新的社会心理健康服务模式以减轻神经精神疾病的负担

已经介绍了将精神卫生保健核心软件包纳入常规初级卫生保健的一种有效方法，以实现精神卫生保健的全民健康覆盖。基于伊朗精神卫生保健的过渡，从在PHC中引入基本精神卫生保健到城市地区基于社区的精神卫生中心的经验，到目前为止，已经提出了一种新的社会心理卫生服务模式。这项研究旨在估算在国家一级扩大新的社会心理健康模型的影响及其相关成本。这项研究是根据“一种健康工具”方法进行的成本后果分析。这项研究所需的数据是在2020年第一季度收集的，时间跨度为2020年至2030年。概括健康影响的选定指标是获得的健康寿命。记录了在药物和供应，员工薪水和门诊就诊方面使用的资源，并随后估算了相关费用，以便估算每例每种干预措施的平均费用。在调整每种疾病的患病率和发病率之后，将根据2020-2030年获得的健康生命年来计算健康影响。总共有望获得1,702,755个健康生命年。考虑到在基本情况下的总成本1,363,581,654美元，获得的每条健康生命年的成本约为801美元。根据WHO的成本效益阈值标准，考虑到2018年伊朗的人均GDP为5550美元，通过八种不同情景获得的所有值都在724到1119美元之间，被认为是具有成本效益的。伊朗的精神卫生预算约占卫生总支出的百分之三而人均精神卫生费用估计为1.73美元，考虑到MNS疾病在国家疾病负担中所占的比例，这是相对较低的。当前的研究结果显示，人均16.4美元的费用可以扩大这种全面的精神卫生服务模式，这可以说服高层决策者相应地增加精神卫生预算的份额。本研究表明，与伊朗人均GDP相比，这种新的社会心理服务模型的成本并不高。