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Factors that influence the cost of caring for patients with severe psychotic illness

Report from the UK 700 trial

Centre for the Economics of Mental Health, Institute of Psychiatry, London

JULIE A. BARBER, MSc

MRC Clinical Trials Unit, London

MATTHEW FIANDER, MSc

Department of General Psychiatry, St George's Hospital Medical School, London

SARAH MARSHALL, MA

School of Psychiatry and Behavioural Sciences, Manchester Royal Infirmary, Manchester

JOHN GREEN, PhD

Psychology Department, Paterson Centre, London

Correspondence: Sarah Byford, Centre for the Economics of Mental Health, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Tel: 020 7848 0043; Fax: 020 7701 7600; e-mail: s.byford{at}iop.kcl.ac.uk

Declaration of interest Funded by the UK Department of Health and NHS Research and Development programme.

Background Many factors influence the type and quantity of services received by patients and, thus, the total cost of care. Knowledge of these factors can aid budgetary and service-planning decisions.

Aims To investigate factors that influence the cost of caring for patients with severe psychotic illness.

Method Univariate and multivariate analyses were used to examine associations between baseline characteristics and subsequent 2-year total direct costs in 667 patients from the UK 700 case management trial.

Results Significantly more money was spent on younger patients, those with longer duration of illness, those who had spent less time living independently and those who had spent longer in hospital for psychiatric reasons.

Conclusions Total costs of caring for patients with severe psychotic illness appear to be influenced to a large extent by age, duration of illness and past levels of dependence on statutory services. The strength of these relationships is greater than the impact of illness severity.

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