OBJECTIVES:

Individuals with mental health disorders (MHDs) have more physical health problems than the general population and use healthcare services more frequently and intensively. Our objective was to estimate the annual hospital care costs of excess physical comorbidities in patients with MHDs in Europe.

METHODS:

Hospital care costs associated with excess physical comorbidities of the working-age population with depressive disorder (DD), bipolar disorder (BD), schizophrenia (SZ), and alcohol use disorder (AUD) were modelled for 2019 in EU-27 countries, plus Iceland, Liechtenstein, Norway, Switzerland, and the United Kingdom. Excess physical comorbidity diagnoses were derived from an auxiliary epidemiological model synthesising data from published literature, meta-analyses, and the Global Burden of Disease 2019 study. Hospital care costs were estimated based on inpatient care and accident and emergency care (A&E). Country-specific inpatient and A&E care use data and costs were obtained from EuroStat, supplemented by data from national sources, and estimated separately for comorbidities by ICD-10 chapters in Euro (€).

RESULTS:

Excess physical comorbidity-related hospital care costs in Europe for 2019 were estimated at €11.5 billion for patients with DD (98% inpatient, 2% A&E care), for patients with BD at €6.3 billion (94% inpatient, 6% A&E care), for patients with SZ at €2.2 billion (88% inpatient, 12% A&E care), and for patients with AUD at €12.9 billion (87% inpatient, 13% for inpatient). Additional costs per patient in the working-age population were the highest for BD (€857), followed by SZ (€725), AUD (€610), and DD (€360).

CONCLUSIONS:

This is the first comprehensive and comparable international estimation of hospitalisation costs associated with excess physical comorbidities in patients with MHDs in Europe, reflecting the potential value of better integrated care and prevention strategies. Our results indicate substantial additional costs and are in line with the existing few cost-of-illness calculations for some individual European countries.