| 1. |
- Helldin, L, et al.
(författare)
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Costs for Schizopsychotic Patients in Sweden
- 2009
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Konferensbidrag (refereegranskat)abstract
- 199 patients in Western Sweden with chronic psychotic illness are studied. The aim is to provide up-to-date costs for a defined patient population with schizopsychotic disorders in Sweden. Patients have the diagnoses of schizophrenia, schizoaffective disorder or delusional disorders. We identify the actual clinical management of illness and explain cost variability. Costs are combined with information on outcomes and severity of the disorder.Total costs per patient-year amount to 62.320 Euro. Direct costs correspond to 41% and indirect costs to 59% of total costs. Inpatient and outpatient care corresponds to 7% each of total costs, while costs for special housing and assistance at home is estimated to 22% of total costs. Medication only corresponds to 3% of total costs.We conclude that costs differ between patients depending on illness severity. Also a reallocation has taken place during the last 15 years between different cost items, from direct costs to indirect costs and from in-patient care at hospitals to out-patient care and assistance at home. The main cost driver is indirect costs due to decreased working ability and premature death. Special housing and home-assistance is the second largest cost item. In-patient care corresponds to 7% of total costs, which 15 years ago amounted to 50% of total costs. This reflects the change in care of schizopsychotic patients. Instead of treating patients at institutions, patients are now to a large extent living in their own housing but often receiving some kind of assistance at home provided by the local municipality.
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| 2. |
- Hjortsberg, Catharina, et al.
(författare)
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Costs for patients with psychotic illness : differences depending upon state of remission
- 2011
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Ingår i: The Journal of Mental Health Policy and Economics. - Milano. - 1091-4358. ; 14:2, s. 87-93
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Tidskriftsartikel (refereegranskat)abstract
- Psychotic illnesses have a substantial economic burden on patients, family members, friends, and society in general, still there have been limited attempts to estimate the costs associated with this condition. Moreover, nothing is known about the differences in costs between patients depending on disease severity, i.e. state of remission.AIM:Estimate the direct and indirect costs for a defined patient population with psychotic illness in Sweden, and demonstrate differences in direct costs depending on disease severity (state of remission).MATERIALS AND METHODS:The cost analyses are based on data from the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), which is an ongoing, single-centre, epidemiological study. Resource use and disease severity were captured for the patients during one year, 2007. Total costs per patients are estimated and cost differences between patients, depending on state of remission, are considered.RESULTS:199 patients with a mean age of 51 (63% men) were followed for 12 months. They had a mean of 6.4 inpatient-days, 1.4 physician visits, 18.6 nurse visits, 1.2 counsellor visits and 6.3 visits to other staff including tests and diagnostic procedures per patient- year. The mean total cost (direct and indirect) amounted to 62,500 per patient and year. Patients in steady state of remission had lower direct costs compared to other patients. Moreover, the size of the various cost items differed between patients' depending on state of remission. Patients in steady remission had almost no inpatient costs.DISCUSSION:For a comprehensive assessment of treatment of psychotic illnesses it is necessary to provide evidence of the costs related to disease severity. We find that patients suffering from psychotic illness have varying costs depending on their disease severity, and this study indicates that if patients can be kept in remission direct costs will decrease. We can also confirm that reallocation has taken place the last 15 years, between different cost items, from in-patient care at hospitals to out-patient care and assistance at home.LIMITATIONS:Information about informal care was collected from patients and not from informal carers themselves.IMPLICATIONS FOR HEALTH CARE PROVISION AND USE:Costs have been reallocated from in-patient care to costs for assistance at home, which is a reflection of the change in care of patients with mental problems that has taken place during the last 15 years. Patients in steady remission have lower costs compared to patients in steady non-remission or patients switching between the two states. A better surveillance of the disorder would lead to lower direct, as well as indirect, costs.
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| 3. |
- Hjortsberg, C, et al.
(författare)
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Direct and indirect costs for psychotic illness in Sweden
- 2010
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Rapport (refereegranskat)abstract
- In this study the direct and indirect costs for a defined patient population with psychotic illness in Sweden was estimated. The cost analyses are based on data from the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), which was an ongoing, single-centre, epidemiological study at the time of this study. A bottom-up costing approach was used to estimate the total costs for schizophrenia, schizoaffective and delusional disorders in Sweden for 2007. Resource use were captured for the patients during one year. 199 patients with a mean age of 51 (63% men) were followed for 12 months. They had a mean (median) of 6.4 (0) inpatient-days, 1.4 (1.2) physician visits, 18.6 (8.4) nurse visits, 1.2 (0) counsellor visits and 6.3 (1.2) visits to other staff including tests and diagnostic procedures per patient- year. The mean cost in our study amounted to 578,000 per patient year which translates to an estimated cost of illness of 16.8 billion SEK for Sweden. Schizophrenia and related disorders significantly interferes with professional activities and as a result, the total burden on society is great. A reallocation has taken place the last 15 years, between different cost items, from direct costs to indirect costs and from in-patient care at hospitals to out-patient care and assistance at home.
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