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Understanding differences in resource use between patient groups is required for decision- making in clinical practice and health care policy. The overall aim of this research project was to show whether patient-specific resource use of inpatient mental health care can be inferred from patient characteristics. This aim was subdivided into four objectives, namely 1) to analyse the association between patient characteristics and length of stay, 2) to synthesise current scientific knowledge considering the association between patient characteristics and per diem resource use, 3) to analyse differences in per diem staff time use between patient groups and 4) to analyse patient-specific determinants of total per diem hospital costs. A systematic review was carried out to synthesise the current knowledge. Data of consecutively sampled patients were used to analyse the association between length and intensity of care and patient and service characteristics. A work time study was used to measure differences in staff time use. Eight potential cost drivers were identified on the basis of previous studies. Strong and significant effects on length and intensity of care were found in both patient and service characteristics. It was neither possible to reliably predict length of stay nor to reliably predict the intensity of care. Idiosyncrasies of inpatient mental health care might have hindered the identification of patient groups that are homogenous in terms of resource use. Decision makers in clinical practice and health policy should be aware of potential differences in resource use between apparently similar patients.