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Service provision for people with schizophrenia

I. Clinical and economic perspective

Published online by Cambridge University Press:  03 January 2018

F. H. Lang ,
E. C. Johnstone ,
G. D. Murray  and
J. F. Forbes
F. H. Lang*
Affiliation:
Department of Psychiatry, Royal Edinburgh Hospital
E. C. Johnstone
Affiliation:
Department of Psychiatry, Royal Edinburgh Hospital
G. D. Murray
Affiliation:
Medical Statistics Unit, Edinburgh University
J. F. Forbes
Affiliation:
Department of Public Health Sciences, Edinburgh University
*
Dr F. H. Lang, Department of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
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Abstract

Background

The aim of this study was to provide information on patients' current service use which could inform future decisions on service planning and resource allocation.

Method

Individuals with a diagnosis of schizophrenia, who had received in-patient care in the previous five years, were identified from the Lothian Case Register. Information was obtained from 193 subjects. Patients' service use over a six-month period was examined. The costs incurred in service provision were determined.

Results

Patients differed markedly in their use of services. This was not found to be related to their mental state. Average care costs were high. In-patient care accounted for most of the overall expenditure.

Conclusions

There is considerable variation in the services used by patients with schizophrenia and in the costs incurred in service provision. When planning services it is therefore important that detailed information on the patient population is available if resources are to be allocated cost-effectively.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 2 , August 1997 , pp. 159 - 164
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

REFERENCES

Ammons, R. B. & Ammons, C. H. (1962) Quick Test. Missoula. MT: Psychological Test Specialists.Google Scholar
Attkinson, C. C. & Zwick, R. (1985) The Client Satisfaction Questionnaire: Psychometric properties and correlation with service utilization and psychotherapy outcome. Evaluation and Program Planning, 5, 233–237.CrossRefGoogle Scholar
Beecham, J. & Knapp, M. (1992) Costing psychiatric options. In Measuring Mental Health Needs (eds G. Thornicroft, Brewin C. & J. Wing), pp. 167–172. Oxford: Oxford University Press.Google Scholar
Chaudhary, M. A. & Stearns, S. C. (1996) Estimating confidence intervals for cost-effectiveness ratios: an example from a randomised trial. Statistics in Medicine, 15, 1447–1458.Google Scholar
Conway, A. S., Molzer, D. & Hale, A. S. (1994) The outcome of targeting community mental health services: evidence from the West Lambeth schizophrenia cohort. British Medical Journal, 308, 627–630.Google Scholar
Davias, L. M. & Drummond, M. F. (1990) The economic burden of schizophrenia. Psychiatric Bulletin, 14, 522–525.Google Scholar
Davias, L. M. & Drummond, M. F. (1994) Economics and schizophrenia: the real cost. British Journal of Psychiatry, 165 (suppl. 25), 18–21.Google Scholar
Efron, B. & Tibshirani, R. J. (1993) An Introduction to the Bootstrap. New York: Chapman and Hall.CrossRefGoogle Scholar
Faighner, J. P., Robins, E., Guze, S., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–62.Google Scholar
Goldberg, D. (1991) Cost-effectiveness studies in the treatment of schizophrenia: a review. Schizophrenia Bulletin, 17, 453–459.CrossRefGoogle Scholar
Guy, W., (1976) ECDEU Manual for Psychopharmacology, pp. 534–537. Washington, DC: Department of Health Education & Welfare.Google Scholar
Hallam, A., Beecham, J., Knapp, M., et al (1994) The costs of accommodation and care. Community provision for former long-stay psychiatric hospital patients. European Archives of Psychiatry and Clinical Neuroscience, 243, 304–310.CrossRefGoogle ScholarPubMed
Jablensky, A., Schwartz, R. & Tomov, T. (1980) WHO collaborative study of impairments and disabilities associated with schizophrenic disorders. A preliminary communication. Objectives and methods. Acta Psychiatrica Scandinavica 62 (suppl. 285) 152–163.CrossRefGoogle Scholar
Johnstone, E. C., (ed.) (1991) Disabilities and circumstances of schizophrenia patients – A follow-up study. British Journal of Psychiatry, 153, Suppl. 13.Google Scholar
Johnstone, E. C. & Lang, F. H. (1994) Onset, course and outcome of schizophrenia. Current Opinion in Psychiatry, 7, 56–60.Google Scholar
Johnstone, E. C., Owens, D. & Gold, A (1981) Institutionalisation and the deficits of schizophrenia. British Journal of Psychiatry, 139, 195–203.Google Scholar
Kavanagh, S., Opit, L., Knapp, M., et al (1995) Schizophrenia: shifting the balance of care. Social Psychiatry and Psychiatric Epidemiology, 30, 206–212.Google Scholar
Knapp, M., Beecham, J., Koutsogeorgopoulou, V., et al (1994) Service use and costs of home-based versus hospital-based care for people with serious mental illness. British Journal of Psychiatry, 165, 195–203.CrossRefGoogle ScholarPubMed
Krawiocka, M., Goldberg, D. & Vaughan, M. (1977) A standardised psychiatric assessment for rating chronic psychotic patients. Acta Psychiatrica Scandinavica, 55, 299–308.CrossRefGoogle Scholar
Larsen, D. H., Attkinson, C. C., Hargreaves, W. A., et al (1979) Assessment of client/patient satisfaction: development of a general scale. Evaluation and Program Planning, 2, 197–207.Google Scholar
Neill, J. E., Warburton, W. E. & McGuiness, B. (1976) Post-Seebohm social services. I: The social worker's viewpoint. Social Work Today, 8, 9–14.Google Scholar
Nelson, H. E. & O'Connell, A. (1978) Dementia: the estimation of premorbid intelligence using the New Adult Reading Test. Cortex, 14, 234–244.Google Scholar
Reid, W. H. (1994) The treatment of psychosis: resetting the drug cost “thermostat”. Journal of Clinical Psychiatry, 55 (suppl. B). 166–168.Google Scholar
Schonell, F. J. (1942) Backwardness in the Basic Subjects. Edinburgh: Oliver and Boyd.Google Scholar
StataCorp (1997) Stata Statistical Software: Release 5.0. College Station. TX: Stata Corporation.Google Scholar
Wojcik, J. D., Gelenberg, A. G., Labrie, R. A., et al (1980) Prevalence of tardive dyskinesia in an out-patient population. Comparative Psychiatry, 21, 370–380.CrossRefGoogle Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases. Geneva: WHO.Google Scholar
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