Micro-costing analysis of a community-based psychiatric intervention among people who inject drugs in Haiphong, Vietnam.
Philippe Trouiller, Sao Mai Le, Giang Hoang Thi, Huong Duong Thi, Oanh Khuat Thi Hai, Tuyet Thanh Nham Thi, Jean-Pierre Moles, Didier Laureillard, Don C Des Jarlais, Nicolas Nagot, Laurent Michel, Nathalie Pelletier-Fleury
Abstract
Open AccessIntroduction: Community-based interventions and peer-support have been shown to improve health outcomes and are increasingly promoted in mental health care. To guide further policy makers, we aimed to estimate, from a societal perspective, the cost of a community based psychiatric intervention for people who inject drugs (PWID). Methods: From March 2022 to May 2022 in Hai Phong, Vietnam, PWID currently or previously diagnosed with a psychiatric disorder were recruited in a 12 months follow-up cohort and received psychiatric and harm-reduction services supported by peers (Drive-Mind 2 cohort study, NCT05886504). Using a micro-costing approach, we estimated the annual per-participant cost for screening PWID for psychiatric disorders, and for providing them for follow-up care and medicine. Findings: All 563 participants who were enrolled in Drive-Mind-2 were screened for psychiatric disorder, and 185 of them were included in a psychiatric follow-up. The total cost of the psychiatric intervention was estimated at $88.7 per participant per year. Recurring goods and services represented 44% of total costs (including medication and transport allowance) and human resources represented 37%. The cost of one screening visit was estimated at $9.8 per participant. Conclusions: Costs for a community-based psychiatric intervention were very low in our study. This data can be used by policy makers in Vietnam to improve a mental health system that is poorly developed and expensive for the patient.