Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-18T08:43:42.051Z Has data issue: false hasContentIssue false
  • English
  • Français

Service utilisation and costs of first-contact patients in a community psychiatric service in Italy

Published online by Cambridge University Press:  16 April 2020

Mauro Percudani ,
Giovanni Fattore ,
Gian Carlo Belloni ,
Simone Gerzeli  and
Agostino Contini
Mauro Percudani*
Affiliation:
Department of Mental Health, Hospital of Legnano, Via Candiani 2, 20025, Legnano, Italy
Giovanni Fattore
Affiliation:
CeRGAS, “L. Bocconi” University, Viale Isonzo 23, 20147, Milan, Italy
Gian Carlo Belloni
Affiliation:
Department of Mental Health, Hospital of Legnano, Via Candiani 2, 20025, Legnano, Italy
Simone Gerzeli
Affiliation:
Department of Applied Statistics and Economics “Libero Lenti”, University of Pavia, Pavia, Italy
Agostino Contini
Affiliation:
Department of Mental Health, Hospital of Legnano, Via Candiani 2, 20025, Legnano, Italy
*
*Corresponding author. E-mail address:m.percudani@tin.it (M. Percudani).
Get access

Summary

This study describes service utilisation under routine clinical activity and the costs of providing mental health care for 24 months for the whole population of 330 subjects who had first contact with the Magenta Community Mental Health Centre during one year. The mean age of patients was 42.5 years, and 61% were females. According to ICD 10 criteria, 7% were diagnosed as having schizophrenia, 22% mood disorders, 37% neurotic disorders, 15% personality disorders and 19% other diagnoses. The clinical routine activity was monitored for 24 months from the first contact for each patient. The mean cost for a schizophrenic patient is more than double that of other patients. In-patient activity and community services accounted, respectively, for 49.7% and 50.3% of the total costs. Total health care costs per patient differ widely according to whether patients had been hospitalised during the observation period. Patients with a previous psychiatric contact and a longer duration of illness were more costly than the other patients. Multiple regression analysis was used to assess the association between all the individual variables and costs. For the whole population, the model explains 50% of the cost variation. Higher treatment costs were positively associated with the presence of previous psychiatric contacts and referral to the CPS by other sources than a general practitioner, and negatively associated with age.

Keywords

Community mental health servicesCostsService utilisationFirst-contact patients
Type
Original Article
Information
European Psychiatry , Volume 17 , Issue 8 , December 2002 , pp. 434 - 442
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amaddeo, F., Beecham, J., Bonizzato, P., Fenyo, A., Tansella, M., Knapp, M.The use of a case register to evaluate the costs of psychiatric care. Acta Psychiatr Scand 1997;95:195–198.CrossRefGoogle ScholarPubMed
Amaddeo, F., Beecham, J., Bonizzato, P., Fenyo, A., Tansella, M., Knapp, M.The costs of community-based psychiatric care for first-ever patients. A case register study. Psychol M 1998;28:173–183.Google ScholarPubMed
Davies, L.M., Drummond, M.F.Economics schizophrenia: the real cost. Br J Psychiatry 25(Suppl):1994;18–21.CrossRefGoogle Scholar
Essock, S.M.State-of-the-art challenges for mental health services research. J Ment Health Policy Econ 1999;2(1)9–12.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Fattore, G., Percudani, M., Pugnoli, C., Contini, A.I costi delle prestazioni in psichiatria: unˈanalisi condotta in un centro psicosociale (CPS) pubblico in Lombardia 〚Costs of psychiatric services: a study performed in a public mental centre in Lombardy Region Italy〛. Epidemiol Psychiatr Soc 1997;6:139–147.CrossRefGoogle Scholar
Fattore, G., Percudani, M., Pugnoli, C., Contini, A., Beecham, J.Mental health care in Italy: organisational structure routine clinical activity costs of a community psychiatric service in lombardy region. Int J Soc Psychiatry 2000;46:250–265.CrossRefGoogle ScholarPubMed
Knapp, M.R.J.0Making music out of noise—the cost function approach to evaluation. Br J Psychiatry 1998;173(Suppl 36):7–11.CrossRefGoogle Scholar
Knapp, M.R.J., Almond, S., Percudani, M.Costs of schizophrenia.. In: Maj, M, Sartorius, N, Schizophrenia. Evidence and experience in psychiatry. WPA series. John Wiley & Sons: Chichester; 1999. p. 407–454.Google Scholar
McCrone, P., Thornicroft, G., Parkman, S., Nathaniel-James, D., Ojurongbe, W.Predictors of mental health service costs for representative cases of psychosis in south London. Psychol M 1998;28:159–164.CrossRefGoogle ScholarPubMed
Mirandola, M., Bisoffi, G., Bonizzato, P., Amaddeo, F.Collecting psychiatric resources utilisation data to calculate costs of care: a comparison between a service receipt interview and a case register. Soc Psychiatry Psychiatr Epidemiol 1999;34:541–547.CrossRefGoogle Scholar
Percudani, M., Belloni, G., Contini, A., Barbui, C.Monitoring community psychiatric services in Italy: differences between patients who leave care and those who stay in treatment. Br J Psychiatry 2002;180:254–259.CrossRefGoogle ScholarPubMed
Rice, D.P., Miller, L.S.Health economics cost implications of anxiety other mental disorder in the United States. Br J Psychiatry 1998;173 (34):4–9.CrossRefGoogle Scholar
PSICOS Group Salvador-Carulla, L.Service utilisation costs of first-onset schizophrenia in two widely differing health service areas in North-East Spain. Acta Psychiatr Scand 1999;100:335–343.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.