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Routine outcome monitoring in clinical practice: service and non-service costs of psychiatric patients attending a Community Mental Health Centre in Italy

Published online by Cambridge University Press:  16 April 2020

Mauro Percudani ,
Corrado Barbui ,
Jennifer Beecham  and
Martin Knapp
Mauro Percudani*
Affiliation:
Department of Mental Health, Hospital of Legnano, Via Candiani 2, 20025 Legnano, Milan, Italy
Corrado Barbui
Affiliation:
Section of Psychiatry, Department of Medicine and Public Health, University of Verona, Verona, Italy
Jennifer Beecham
Affiliation:
Centre of the Economics of Mental Health, Health Services Research Department, Institute of Psychiatry, London, UK
Martin Knapp
Affiliation:
Centre of the Economics of Mental Health, Health Services Research Department, Institute of Psychiatry, London, UK
*
*Corresponding author. Email address: [email protected]
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Abstract

Objective.

– This study estimated service and non-service costs in a random sample of patients attending a community psychiatric mental health centre in Italy.

Methods

– A randomly selected sample of patients identified during 1 week of routine clinical activity was enrolled. Information was collected using the Italian-language checklist Questionario Economico per l’attività clinica dei Servizi Psichiatrici (QESP). Costs were classified in two categories: service costs (from the provision of services) and non-service costs (loss of productivity and informal care).

Results.

– One hundred and twenty patients were included. Patients suffering from schizophrenia and related disorders (n = 50) had a mean age of 44.5 years (S.D. 12.9), and patients with other diagnoses (n = 70) had a mean age of 44.9 years (S.D. 14.8). More patients in the schizophrenia group were single, living alone, had a low educational level and a higher unemployment rate. In patients suffering from schizophrenia, the monthly service cost per patient was nearly double that for patients with other diagnoses. Non-service costs associated with patients’ lack of job opportunities were more than three times higher for patients with schizophrenia. Non-service costs associated with patients’ and care-givers’ time off work were similar in the two groups. In the multivariate analysis, being unemployed was associated with higher service costs. Younger age, length of illness and diagnosis of schizophrenia were determinants of higher non-service costs. The latter three independent variables were also associated with overall (service and non-service) costs.

Conclusion.

– The present study estimated service and non-service costs under routine circumstances to provide information on costs that community psychiatric services, patients and care-givers sustain when dealing with psychiatric problems.

Keywords

Community psychiatryCostsSchizophrenia
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 8 , December 2004 , pp. 469 - 477
Copyright
Copyright © European Psychiatric Association 2004

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