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. 2022 Mar 16;19(6):3500.
doi: 10.3390/ijerph19063500.

In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe

Susanne Mayer  1 , Michael Berger  1 , Alexander Konnopka  2   3 , Valentin Brodszky  4 , Silvia M A A Evers  5   6 , Leona Hakkaart-van Roijen  7 , Mencia R Guitérrez-Colosia  8   9 , Luis Salvador-Carulla  10   11 , A-La Park  12 , William Hollingworth  13 , Lidia García-Pérez  14 , Judit Simon  1   15 , On Behalf Of The Pecunia Group
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In Search for Comparability: The PECUNIA Reference Unit Costs for Health and Social Care Services in Europe

Susanne Mayer et al. Int J Environ Res Public Health. .

Abstract

Improving the efficiency of mental healthcare service delivery by learning from international best-practice examples requires valid data, including robust unit costs, which currently often lack cross-country comparability. The European ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) aimed to harmonize the international unit cost development. This article presents the methodology and set of 36 externally validated, standardized reference unit costs (RUCs) for five health and social care services (general practitioner, dentist, help-line, day-care center, nursing home) in Austria, England, Germany, Hungary, The Netherlands, and Spain based on unambiguous service definitions using the extended DESDE PECUNIA coding framework. The resulting PECUNIA RUCs are largely comparable across countries, with any causes for deviations (e.g., country-specific scope of services) transparently documented. Even under standardized methods, notable limitations due to data-driven divergences in key costing parameters remain. Increased cross-country comparability by adopting a uniform methodology and definitions can advance the quality of evidence-based policy guidance derived from health economic evaluations. The PECUNIA RUCs are available free of charge and aim to significantly improve the quality and feasibility of future economic evaluations and their transferability across mental health systems.

Keywords: PECUNIA; economic evaluation; health care; mental health; reference cost; service; social care; societal perspective; unit cost; valuation.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
PECUNIA RUC estimates compatible with the PECUNIA RUM instrument per selected health and social care service for each PECUNIA partner country (in Euro, for year 2019; n = 27). Note: The figure presents the 27 RUCs that are suitable for valuation in combination with the PECUNIA RUM instrument.
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