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- Jonsson, Dick, et al.
(författare)
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The socioeconomic cost of treatment of therapy-refractory schizophrenic patients in Sweden
- 1994
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 48:5, s. 311-313
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study is to examine the socioeconomic costs of treatment of therapy-refractory schizophrenic patients. The patients usually have a great need for health care and remain in institutions for long periods of time. The method is retrospective, and the data refer to patients who received treatment at the Department of Psychiatry, University Hospital in Linköping, Sweden in 1990. The total annual health care cost for treatment of therapy-refractory schizophrenia is estimated to be SEK 4.8 million (USD 1 = SEK 7.7). Inpatient care amounts to 93% of the total cost, and the cost of outpatient care to 6%. The cost of drugs and laboratory services corresponds to 1 % of the total cost. The high cost of inpatient care and the low cost of outpatient care may indicate that a redistribution of resources from inpatient to outpatient care is necessary. A generalization of the results indicates that the total annual cost of treating all therapy-refractory schizophrenic patients in Sweden is approximately SEK 1.9 billion. The result highlights the need for discussions concerning alternative treatment methods but also focuses on the importance of using health economic evaluations within psychiatry.
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| 2. |
- Tysk, Lennart, et al.
(författare)
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Psychiatric inpatient care and the availability of hospital beds : A comparison of three catchment areas
- 1990
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 44:6, s. 559-561
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Tidskriftsartikel (refereegranskat)abstract
- Psychiatric inpatient care and the availability of hospital beds: A comparison of three catchment areas. The psychiatric care in Gävleborg county was formerly centralized to a mental hospital and a small psychiatric department at a general hospital. It was then decided that the care system should be reorganized. The county was divided into three catchment areas. Each of these will have a comprehensive psychiatric care with both in- and out-patient facilities, but the intramural care will be reduced considerably. During the reorganization phase an almost experimental situation existed, as accessibility and availability of hospital beds differed among the three sectors. The inpatients for each sector were counted, and some patient characteristics were compared. Except for a considerable difference in the use of hospital beds small differences were otherwise noted. The sector with the smallest number of inpatients had relatively more schizophrenic patients. The accessibility and availability of hospital beds seemed to decide the number of inpatients even when deinstitutionalization was an accepted common goal. Local habits and traditions may also be important.
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| 3. |
- Wessén, Bernice, et al.
(författare)
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En uppföljning av långtidsvårdade patienter som skrivits ut från sjukhus i samband med psykiatrins omdaning
- 1991
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 45:1, s. 41-45
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Tidskriftsartikel (refereegranskat)abstract
- The so-called sectorization of the psychiatric care system has been connected with deinstitutionalization and possibly also a forced discharge from hospital for some long-term inpatients. In Gävleborg County 96 patients who had been hospitalized for at least 1 year were discharged in the years 1984-88, when the reduction of hospital beds was at its peak. Their situation was investigated in the autumn of 1989, when members of the psychiatric staff evaluated their living conditions and asked the patients to complete a questionnaire. At that time 19 patients had been readmitted to hospital, 4 had moved to other parts of the country, and 3 were dead. Thus at least 70 were still living outside institutions, but 2 of these could not be reached. The material consists of the other 68 patients. Forty of them were diagnosed as being schizophrenic. Twenty-two patients had spent some time in hospital after the index discharge. Forty-three lived in their own lodgings, 14 in group homes, and 11 in homes for the elderly. Forty-one lived alone, and this was more often the case for male patients. Only one had a job and earned his living, but 41 took part in some organized activity like work therapy or study groups. About 50% of the patients had regular contact (at least once a month) with the local psychiatric department, and the same frequency was noted for regular contact with the district nurses. Only seven patients had no such contacts. According to the staffs judgement, about two of three patients had enough psychosocial support and a satisfactory quality of life. Resources for rehabilitation, activation, and social contacts were reported to be inadequate. The patients had a more positive view and were largely satisfied with their living conditions. Only four wanted to return to the hospital. The schizophrenic patients tended to have a more satisfactory life situation according to the staff, and they were also rehospitalized less frequently than other patient categories. There is a notable group of chronically ill patients with other psychiatric diagnoses, which need as much support as the schizophrenic group. When resources are lacking, the need for cooperation with social authorities, primary care, and clients' organizations is apparent.
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