title: Impact of risperidone on the use of mental health care resources.
abstract: OBJECTIVE
  The effects of risperidone treatment on health care utilization and treatment costs were examined among patients with treatment-refractory schizophrenia or schizoaffective disorder.
  
  
  METHODS
  Data from the Santa Clara County Mental Health Department were used to measure inpatient and ambulatory services and outpatient medications related to the treatment of mental disorders. Data for 139 patients were analyzed for periods before and after initiation of risperidone treatment. A mean +/- SD of 14 +/- 2.1 months of data were available in both the before and after periods, for a mean total study period of 28 months.
  
  
  RESULTS
  The patients' mean age was 40 years (range, 18 to 78 years), and 46 percent were women. After the start of risperidone treatment, days in acute care inpatient facilities were reduced by 26 percent, and days in residential treatment were reduced by 57 percent. These reductions were accompanied by an increase in the use of lower-cost services, such as community living, treatment planning, and partial hospital-day treatment. There was a 3.4 percent increase in total psychiatric health care costs after initiation of treatment with risperidone.
  
  
  CONCLUSIONS
  Overall, risperidone treatment resulted in a shift or resource utilization from provider-delivered services to pharmaceutical care without a significant change in total health care cost.
authors.affiliation: University of California, San Francisco, USA.
authors.forename: G
authors.initials: G
authors.lastname: Viale
authors.forename: L
authors.initials: L
authors.lastname: Mechling
authors.forename: G
authors.initials: G
authors.lastname: Maislin
authors.forename: M
authors.initials: M
authors.lastname: Durkin
authors.forename: L
authors.initials: L
authors.lastname: Engelhart
authors.forename: B J
authors.initials: BJ
authors.lastname: Lawrence
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D014150:Antipsychotic Agents / Q000191:economics / Q000627:therapeutic use*; D002140:California / Q000453:epidemiology; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D017723:Drug Utilization Review; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D018967:Risperidone / Q000191:economics / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents; D018967:Risperidone