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Costs of psychiatric residential care in Italy

  • Laura Grigoletti (a1), Francesco Amaddeo (a1), Giovanni de Girolamo (a2), Angelo Picardi (a3) and Gruppo Nazionale Progres (a4)...


Objective – The aims of this study are: (1) to estimate patients' costs in Italian non hospital Residential Facilities (RF); (2) to analyse the relationship between the costs of care received by residents and patients' or facilities characteristics. Method – The PROGRES study included all Italian private and public RF (1370) with more than 4 beds. Of those, 265 were selected through stratified random sampling to be included in phase 2. Data were obtained through a schedule filled in by the facility manager. Additional information about costs related to the use of Community Psychiatric Service (CPS) by residents has also been collected. The cost components of residential accommodation include the costs of the RF, of the CPS, of general medical care, of the informal assistance provided by family or friends, and other non-medical costs. Results – The mean annual cost of stay in RFs was approximately 34,000 Euro, and it was related to the RF size and to staffing levels. Both RF and CPS are more expensive in the north of Italy, as compared to the center and the south. Costs were lower for older patients. CPS costs are lower when RF staffing levels are higher. Conclusions – In general, patients in RFs cost between 20,000 and 40,000 Euro per year; to this sum, additional 2,000-6,000 Euros per year should be added to include the costs of care provided outside the facility. Both RFs and CPS have different costs depending on the geographical area where the facilities are located, and staffing levels. Changes in CPS costs seem to be related to patients' characteristics.

Declaration of Interest: none


Corresponding author

Address for correspondence: Dr. L. Grigoletti. Dipartimento di Medicina e Sanità Pubblica. Sezione di Psichiatria e Psicologia Clinica. Policlinico G.B. Rossi. P.le L.A. Scuro 10, 37134 Verona (Italy). Fax: +39-045-8074.889 E-mail:


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Amaddeo, F., Bonizzato, P., Beecham, J. & Tansella, M. (1996). ICAP. Un'intervista per la raccolta dei dati necessari per la valutazione dei costi dell'assistenza psichiatrica. Epidemiologia e Psichatria Sociale 5, 211222.
Amaddeo, F., Beecham, J., Bonizzato, P., Fenyo, A., Tansella, M. & Knapp, M. (1998). The costs of community-based psychiatric care for first-ever patients. A case register study. Psychological Medicine 28.173183.
Bonizzato, P., Bisoffi, G., Amaddeo, F., Chisholm, D. & Tansella, M. (2000). Community-based mental health care: to what extent are services costs associated with clinical, social and service history variables? Psychological Medicine 30. 12051215.
Chisholm, D., Knapp, M.Astin, J., Lelliott, P. & Audini, B. (1997). The mental health residential care study: predicting costs from resident characteristics. British Journal of Psychiatry 170. 3742.
Gruppo Nazionale PROGRES (2001). Le strutture residenziali psichiatriche in Italia. I risultati della fase 1 del progetto PROGRES. Epidemiologia e Psichiatria Sociale 10, 260275.
De Agostini, P., Bonizzato, P., Amaddeo, F., Bisoffi, G., Perali, F. & Tansella, M. (2001). Per un piu razionale sistema di finanziamento dei Dipartimenti di Salute Mentale. Analisi dei costi delle prestazioni erogate da un Servizio Psichiatrico Territoriale in un periodo di 7 anni. Epidemiologia e Psichialria Sociale 10(3). 163179.
de Girolamo, G., Picardi, A., Micciolo, R., Falloon, I., Fioritti, A. & Morosini, P. for the Italian PROGRES study group (2002). Residential care in Italy: a national survey of non-hospital facilities. British Journal of Psychiatry 181.220225.
Felce, D. (1981). The capital costs of alternative residential facilities for mentally handicapped people. British Journal of Psychiatry 193. 230237.
Fenton, W.S., Mosher, L.R., Herrell, J.M. & Blyler, C.R. (1998). Randomized trial of general hospital and residential alternative care for patients with severe and persistent mental illness. American Journal of Psychiatry 155. 516522.
Fenton, W.S., Hoch, J.S., Herrell, J.M., Mosher, L.Dixon, L. (2002). Cost and cost-effectiveness of hospital vs residential crisis care for patients who have serious mental illness. Archives of General Psychiatry 59(4). 357364.
Hawthorne, W.B., Fals-Stewart, W. & Lohr, J.B. (1994). A treatment out-come study of community-based residential care. Hospital and Community Psychiatry 45(2). 152155.
Knapp, M., Chisholm, D., Leese, M, Amaddeo, F., Tansella, M., Schene, A., Thornicroft, G., Vazquez-Barquero, J.L., Knudsen, H.C., Becker, T., EPSILON. European Psychiatric Services: Inputs Linked to Out-come Domains and Needs. (2002). Comparing patterns and costs of schizophrenia care in five European countries: the EPSILON study. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs. Ada Psychiatrica Scandinavica 105(1), 4254.
Leff, J., Trieman, N., Knapp, M. & Hallam, A. (2000). The TAPS Project. A report on 13 years of research. 1985-1998. Psychiatric Bulletin 24, 165168.
Mirandola, M., Amaddeo, F., Dunn, G. & Tansella, M. (2003). Predicting one year costs for patients with different psychiatric history attending a community-based mental health service. Ada Psychiatrica Scandinavica 109, 132139.
Morosini, P.L., Magliano, L., Brambilla, L., Ugolini, S. & Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Ada Psychiatrica Scandinavica 101, 323329.
C, MunizzaDonna, G., Nieddu, S. (a cura di) (1999). Finanziamento e Management del Dipartimento di Salute Mentale. Edizioni II Mulino: Bologna.
O'Driscoll, C. & Leff, J. (1993). The TAPS Project. 8: Design of the research study on the long-stay patients. British Journal of Psychiatry 19, Suppl. Apr.. 1824.
Richardson, G., Davies, L., South, B., Proctor, R., Burns, A., Stratlon, Powell H., Tarrier, N. & Faragher, B. (2000). Economic impact of a specialist outreach team in residential and nursing home settings. Journal of Mental Health Policy and Economics 3(3), 147152.
Rosenheck, R., Kasprow, W., Frisman, L. & Liu-Mares, W. (2003). Cost-effectiveness of supported housing for homeless persons with mental illness. Archives of General Psychiatry 60(9), 940951.
Sledge, W.H., Tebes, J., Wolff, N. & Helminiak, T.W. (1996). Day hospital/crisis respite care versus inpatient care. Part II: service utilization and costs. American Journal of Psychiatry 153. 10741083.
Stata Corporation (2001). STATA Statistical Software: Release 7.0. STATA Corporation: College Station. TX.
Wing, J.K., Beevor, A.S., Curtis, R.H., Park, S.B., Hadden, S. & Burns, A. (1998). Health of the Nation Outcome Scales (HoNOS). Research and development. British Journal of Psychiatry 172,1118.
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Epidemiology and Psychiatric Sciences
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