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The economic perspective in the care and treatment of patients with diagnosis of schizophrenia

Published online by Cambridge University Press:  11 October 2011

Mauro Percudani  and
Martin Knapp
Mauro Percudani*
Affiliation:
Unità Operativa di Psichiatria di Magenta, Ospedale Civile di Legnano, Legnano (Mi)
Martin Knapp
Affiliation:
London School of Economics and Institute of Psychiatry, London, UK
*
Indirizzo per la corrispondea: Dr. Percudani Unità Operativa di Psichiatria - CPS, Via Fornaroh 67, 20013 Magenta (Milano) Fax: +39 - 02-9729.1354
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Summary

Objective - To consider the main problems associated with care and treatment of patients with diagnosis of schizophrenia in the light of the more recent literature of the economic aspects of this pathology. Method - An analysis of the literature related to the social costs of schizophrenia, the economic analysis of different health-care models, and the evaluation of the costs of antipsychotic treatments has been carried out. Results - Schizophrenia is a pathology creating huge social costs. The health costs associated with the care of schizophrenia take up a significant amount of the resources of healthcare systems in the principal industrialised countries. Indirect costs, due mainly to the patients' exclusion from work, exceed the direct costs of treatment. In those countries where community care has been supported by a real organisational effort to create community and residential services, it has proved to be a cost-effective solution compared with psychiatric hospital-based care and provides patients and family members with better results. The introduction of new antipsychotic drugs and the development of psychosocial support could represent the means of encouraging new healthcare strategies. Conclusions - From an economic perspective, the organisation, technological means, and strategies which would allow the available resources to be invested in a rational way must be considered. Consideration of these issues appears to be unavoidable today, not only for the administrators and the policy makers but also for mental health service professionals.

Riassunto

Scopo - Considerare le principali problematiche connesse all'assistenza ed al trattamento dei pazienti con diagnosi di schizofrenia alia luce della piu recente letteratura sugli aspetti economici di questa patologia. Metodo - È stata effettuata una analisi della letteratura relativa ai costi sociali della schizofrenia, all'analisi economica di diversi modelli di assistenza, alia valutazione dei costi dei trattamenti antipsicotici. Risultati - La schizofrenia è una patologia che genera ingenti costi sociali. I costi sanitari legati all'assistenza alia schizofrenia assorbono una percentuale significativa delle risorse dei sistemi sanitari dei principali paesi industrializzati. I costi indiretti, dovuti principalmente al mancato inserimento al lavoro dei pazienti, risultano superiori ai costi diretti di trattamento. Nei paesi ove l'assistenza centrata sul territorio è stata supportata da un reale sforzo organizzativo per la creazione di servizi territoriali e residenziali, è emerso che essa è meno costosa dell'assistenza centrata sull'ospedale psichiatrico e genera un miglior esito per pazienti e familiari. L'introduzione di nuovi farmaci antipsicotici e lo sviluppo di interventi di tipo psicosociale possono rappresentare strumenti che favoriscono nuove strategie di assistenza. Conclusion! - Utilizzare una prospettiva economica implica pensare a quale organizzazione, quali strumenti tecnologici, quali strategie permettono di investire con razionalita le risorse disponibili. Una riflessione su questi temi appare oggi ineludibile non solo per gli amministratori ed i decisori politici, ma anche per gli operatori dei servizi di salute mentale.

Keywords

schizofreniavalutazione economicacosti socialiassistenza psichiatricaantipsicoticischizophreniaeconomic evaluationsocial costspsychiatric careantipsychotic drugs
Type
Articles
Information
Epidemiology and Psychiatric Sciences , Volume 7 , Issue 3 , December 1998 , pp. 197 - 209
Copyright
Copyright © Cambridge University Press 1998

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