[The influence of community support services on the costs of treatment of chronically mentally ill patients].
OBJECTIVE
To determine changes in costs of treatment for chronically mentally ill patients after their admittance to new social help units; Vocational Rehabilitation Center, Community Center of Mutual Help and Specialised Social Help Services at Client's Home.


METHODS
In the group of 73 chronically mentally ill persons, for two years before and after their admission to social help units, the global amount of care (months x persons) and all the costs (PLN) in both social help and mental health systems were compared.


RESULTS
For two years after the admission to the mentioned services all the costs in mental health system were significantly decreasing (71.9%), but new costs in social welfare system emerged. The overall costs of care were higher than before, but the elevation (35.4%) of all the costs was not so high as the increase (99,3%) of the care. The structure of care was improved (more day-, and less stationary care). The "out of the pocket" expenses for patients increased.


CONCLUSIONS
The implementation of social help services for chronic mentally ill patients is reducing the amount of stationary and day treatment, but increasing active community treatment. Money in the health system is saved, but all the expenses on community care are increased. Coordination of care and finances between the mental health and social welfare is needed. Common financing for both systems is questionable because of impending over medicalisation. The allocation of money saved to early rehabilitation in schizophrenia would be profitable in the future.
Załuska
Maria
M
IV Kliniki Psychiatrii IPiN w Warszawie.
Suchecka
Dorota
D
Traczewska
Zofia
Z
Paszko
Jolanta
J
D000328:Adult; D003156:Community Mental Health Services / Q000191:economics*; D003365:Costs and Cost Analysis; D003631:Day Care, Medical / Q000191:economics; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000534:rehabilitation*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011044:Poland; D012050:Rehabilitation, Vocational / Q000191:economics*; D012189:Retrospective Studies; D012944:Social Support; D012946:Social Welfare / Q000191:economics*; D012949:Social Work, Psychiatric / Q000191:economics*; D013997:Time Factors