Background:
In a climate of intense debate about where to invest scarce resources in Australia's mental health treatment system, to achieve optimal outcomes, ‘real-world’ studies, such as the Schizophrenia Care and Assessment Program, provide comprehensive and broad-ranging data that undermine ‘hypothetically’ based models that deter investment in low-prevalence disorders such as schizophrenia.
Methods:
A cohort of 347 patients with schizophrenia was followed up over 3 years. Clinical outcomes were assessed at 6 monthly intervals, and resource utilization and costing data was collected continuously from internal and external databases as well as from participants directly.
Results:
The majority of participants showed significant improvement in clinical outcome measures of symptomatology, functioning and quality of life, although the level of employment remained low throughout the study. A small minority of participants consumed a disproportionate amount of resources and costs. Despite an increase in the use of the more expensive atypical antipsychotic medications, the total treatment costs for the cohort decreased significantly over the course of the study, largely related to a reduction in hospitalizations.
Conclusions:
For the majority of people with schizophrenia, investment in assertive treatment programs and measures to reduce hospitalization will result in enhanced functioning and quality of life, as well as a reduction in long-term societal and government costs. Investment in employment rehabilitation programs is an important step to completing the positive gains made by people like those who participated in the Australian SCAP.
