Hostname: page-component-7c8c6479df-27gpq Total loading time: 0 Render date: 2024-03-27T00:12:12.441Z Has data issue: false hasContentIssue false

Utilisation of mental health services and costs of patients with schizophrenia in three areas of Spain

Published online by Cambridge University Press:  03 January 2018

Josep Maria Haro*
Affiliation:
Centre de Salut Mental de Gavà, Sant Joan de Déu-SSM, Barcelona, Spain
Luis Salvador-Carulla
Affiliation:
Centro de Investigacíon en Minusvalías, Universidad de Cádiz, Spain
Juan Cabasés
Affiliation:
Departamento de Economía, Universidad Pública de Navarra, Spain
Vicente Madoz
Affiliation:
Fundación Argibide, Navarra, Spain
José Luis Vázquez-Barquero
Affiliation:
Unidad de Investigación en Psiquiatría Social, Universidad de Cantabria, Spain
*
Josep Maria Haro, CSM Gavà, Sant Joan de Déu-SSM, Sarría 13-15, E-08850 – Gavá. Barcelona, Spain. Tel: 3493-662-51-52; Fax: 3493-662-55-56; e-mail: 27652jha@comb.es

Abstract

Background

The analysis of the costs of schizophrenia and its treatment under different mental health care structures will facilitate the improved allocation of the limited resources available for the treatment of schizophrenia. The research we present compares health service use and total health care costs of three cohorts of subjects with schizophrenia which are representative of three areas of Spain (Burlada in Navarra, Cantabria and the Eixample of Barcelona).

Method

We selected first-time contacts with any psychiatric service who received a diagnosis of schizophrenia. Subjects were evaluated in the third year after onset.

Results

The mean number of out-patient visits per patient per year was 10.7 and the mean in-patient days were 9.5. The mean direct cost per patient in the third year of treatment was US$2243. Costs were higher for single subjects and for people who had a relapse. Costs of subjects with better functioning were lower than costs of subjects with a worse state.

Conclusions

Direct costs of care in Spain were lower than the reported figures from other western European countries. Costs were greater in the two centres with greater community mental health service development. Some of the findings may be explained by service availability.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM-III-R). Washington. DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). Washington, DC: APA.Google Scholar
Beecham, J. (1995) Collecting and estimating costs. In The Economic Evaluation of Mental Health Care (ed. Knapp, M.). Aldershot: Arena. Ashgate Publishing.Google Scholar
Beecham, J., Knapp, M. & Allen, C. (1995) Comparative efficiency and equity in community based care. In The Economic Evaluation of Mental Health Care. (ed. Knapp, M.). Aldershot: Arena. Ashgate Publishing.Google Scholar
Davies, L. M. & Drummond, M. F. (1994) Economics and schizophrenia: the real cost. British Journal of Psychiatry, 165 (suppl. 25). 1821.Google Scholar
Goldman, H., Morrisey, J., Ridgely, S., et al (1992a) Lessons from the program on chronic mental illness. Health Affairs, II, 5168.CrossRefGoogle Scholar
Goldman, H., Skodol, A. E. & Lave, T. R. (1992b) Revising axis V for DSM – IV: A review of measures for social functioning. American Journal of Psychiatry, 149, 11481156.Google ScholarPubMed
Häfner, H., Maurer, K., Löftier, W., et al (1993) The influence of age on the onset and early course of schizophrenia. British Journal of Psychiatry, 162, 8086.Google Scholar
Hu, T. W., Shumway, M. & Hargreaves, W. A. (1996) Estimating costs of schizophrenia and its treatment. In Schizophrenia (eds Moscarelli, M. Rupp, A. & Sartorius, N.). New York: John Wiley and Sons.Google Scholar
Janca, A., Kastrup, M., Katsonnig, H., et al (1996) The World Health Organization Short Disability Assessment Schedule (WHO-DAS-sv): a tool for the assessment of difficulties in selected areas of functioning of patients with mental disorders. Social Psychiatry and Psychiatric Epidemiology, 31, 349354.Google Scholar
Knapp, M. (1997) Costs of schizophrenia. British Journal of Psychiatry, 171, 509518.Google Scholar
Koopmanschap, M. A., Rutten, F. F. H., Marth van Inevetd, B., et al (1997) The friction cost method for measuring indirect costs of disease. Journal of Health Economics, 14, 171189.CrossRefGoogle Scholar
Left, J., Sartorius, N., Jablensky, A., et al (1992) The international pilot study of schizophrenia: five-year follow-up findings. Psychological Medicine, 22, 131145.Google Scholar
Moscarelli, M. S., Capri, S. & Neri, L. (1991) Cost evaluation of chronic schizophrenic patients during the first three years after first contact. Schizophrenia Bulletin, 17 (suppl. 3). 421426.Google Scholar
Netten, A. & Beecham, J., (eds) (1993) Costing Community Care: Theory and Practice. Aldershot: Ashgate.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799812.Google Scholar
Rice, D. P. & Miller, L. S. (1996) The economic burden of schizophrenia: conceptual and methodological issues, and cost estimates. In Schizophrenia (eds Moscarelli, M. Rupp, A. & Sartorius, N.). New York: John Wiley and Sons.Google Scholar
Salize, H. J. & Rössler, W. (1996) The cost of comprehensive care of people with schizophrenia living in the community. A cost evaluation from a German catchment area. British Journal of Psychiatry, 169, 4248.Google Scholar
Salvador-Carulla, L., Torres, F., Johnson, S., et al (1997) Versión española del European Service Mapping Schedule. Diagrama europeo de servicios. Archivos de Neurobiología, 60, 163169.Google Scholar
Systeme, S., Mkdolo, R. & Lamella, M. (1996) Service utilization by schizophrenic patients in Groningen and South Verona: an event-history analysis. Psychological Medicine, 26, 109119.Google Scholar
Vázquez-Barquero, J. L. (1993) SCAN. Cuestionarios para la Evaluación Cllnica en Neuropsiquiatría. Madrid: Meditor.Google Scholar
Vázquez-Barquero, , Díaz Manrique, J. F., Peña, C., et al (1907) A community mental health survey in Cantabria: a general description of morbidity. Psychological Medicine, 17, 227241.Google Scholar
Vázquez-Barquero, , Cuesta Núñez, M. J., de la Varga, M., et al (1995) The Cantabria first episode schizophrenia study: a summary of general findings. Acta Psychiatrica Scandinavica, 91, 156162.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.