Background. Analysing costs measures in conjunction with
psychiatric case register (PCR) data can
provide important epidemiologically-based information on resource
utilization. Costing the service
use patterns of first-ever patients can indicate the shape and likely
resource consequences for mental
health services operating within a community-based system of care.
Methods. Yearly costs were calculated for the 299
first-ever patients and 768 longer-term patients
who contacted the South-Verona Psychiatric Case Register between 1
January 1992 and 31
December 1993. Bivariate and multivariate analyses were used to
compare costs between these
groups and to test the associations between costs and the sociodemographic
and diagnostic data recorded on the PCR.
Results. For all diagnostic groups identified, first-ever
patients were found to be less costly to
support than longer-term patients, even after adjustment for
various factors, including whether
patients were single consulters. When multivariate analyses were
employed, between 20% and 69%
of the cost variation for first-ever patients could be explained by
patient and other characteristics,
and the effect of the contact (first or subsequent) variable was reduced.
Conclusion. This study considered only the costs to the
specialist psychiatric services but the
methodology allows the likely annual resource implications of supporting
new patients to be
predicted from data collected at first contact. Such information can
help ensure that services are
adequately funded and that the resources are deployed appropriately
between client groups.