Variations in the costs of child and adolescent psychiatric inpatient units

Background: Child and adolescent in-patient care is a highly specialised service, ideally requiring planning at a national level, but there are no routine data collections specifically for these services. Aims: To estimate unit costs for child and adolescent psychiatric in-patient units and to analyse the variations in costs between units. Method: Data collection alongside a national survey with cost estimations guided byprinciples drawn from economic theory. Bivariate and multivariate analyses are employed to identify cost influences. Results: Fifty-eight units could provide sufficient data to allow calculation of the cost per in-patient day; mean=£197 (s.d.=71.6; 1999–2000 prices). The management sector, type of provision, number of rooms, capacity and location explained nearly half of the cost variation. Conclusions: Child and adolescent psychiatric in-patient units are an expensive resource, with personnel absorbing two-thirds of the total costs. Costs per in-patient day vary fourfold and the exploration of cost variations can inform commissioning strategies.