Comparing patterns and costs of schizophrenia care in five European countries: the EPSILON study. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs.
OBJECTIVE
To compare service utilization and cost profiles of people with schizophrenia living in Europe in order to understand differences in treatment and care costs.


METHODS
Cross-sectional samples were taken of people with schizophrenia in five European locations. Sociodemographic, clinical and service use data were collected via interviewer-administered questionnaires. Site-specific unit costs were obtained, transformed subsequently into a single currency (UK pound). Multiple regression analyses were conducted.


RESULTS
There were widespread and considerable differences between sites in service utilization patterns and associated costs. Higher needs, greater symptom severity and longer psychiatric history are associated with higher costs: quality of life and service satisfaction are not. Few differences were found between sites in patterns of association with cost.


CONCLUSIONS
Comparative analyses of the use and cost of mental health services can highlight existing variations helpfully in service provision and uptake. Methodological consistency is required if meaningful conclusions are to be drawn from such comparative data.
Knapp
Martin
M
Department of Health Services Research, Institute of Psychiatry, King's College Medical School, London, UK.
Chisholm
Daniel
D
Leese
Morven
M
Amaddeo
Francesco
F
Tansella
Michele
M
Schene
Aart
A
Thornicroft
Graham
G
Vazquez-Barquero
Jose-Luis
JL
Knudsen
Helle-Charlotte
HC
Becker
Thomas
T
D000328:Adult; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics*; D012559:Schizophrenia / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*