The cost of treating selected psychiatric conditions from the provider’s perspective in a public tertiary academic hospital in South Africa

Front Public Health. 2026 Oct 30;14:1954891. doi: 10.3389/fpubh.2026.1954891. eCollection 2026.

ABSTRACT

BACKGROUND AND OBJECTIVES: Psychiatric disorders share the chronicity and lifelong treatment burden that make the major non-communicable diseases (NCDs) costly to health systems, yet remain comparatively under-costed within the Sub-Saharan African literature on chronic disease burden. Determining the direct costs of treating psychiatric disorders in resource limited settings is important for budget allocation, particularly as South Africa moves towards the National Health Insurance (NHI) fund system. The study aimed to determine the costs of psychiatric outpatient care at a public tertiary hospital in South Africa.

METHODS: The study employed a retrospective quantitative approach, using data from patient files at a public tertiary hospital in Gauteng. Data were captured in Microsoft Excel^TM and analysed in SPSS®. Direct medical costs were assessed using a micro-costing method to determine the yearly, average total cost of care per psychiatric patient. Ethics approval (SMUREC/P/411/2023: PG) and permission to conduct the study were obtained.

RESULTS: The study reviewed 278 patient files and found a significant relationship (p < 0.001) between psychiatric diagnoses and treatment costs. Schizophrenia had the highest average annual cost at R7,248.25 per patient, followed by bipolar disorder at R5,762.10, anxiety disorders at R4,853.14, and depression at R4,792.79. Treatment costs for adverse effects were generally low, except for schizophrenia. Supportive care therapies, such as cognitive behavioural therapy, added moderate expenses, while psychiatric medications were the main cost drivers.

CONCLUSION: The results highlight the necessity for South African public healthcare systems to allocate resources specifically for the treatment of psychiatric conditions, particularly schizophrenia and bipolar disorder, due to their prevalence and significant financial impact in a public tertiary hospital setting. The high costs associated with treating schizophrenia and bipolar disorder underscore the need for ongoing research into more effective and affordable treatment options and for psychiatric disorders to be integrated more fully into the region’s growing evidence base on the economic burden of non-communicable disease.

PMID:43031710 | PMC:PMC13759394 | DOI:10.3389/fpubh.2026.1954891