title: Australian Schizophrenia Care and Assessment Programme: real-world schizophrenia: economics.
abstract: OBJECTIVE
  The treatment of patients with schizophrenia consumes a considerable proportion of health service budgets, yet there have been few attempts to prospectively analyse the costs associated with this condition. Amid the current debate about where to invest scarce treatment resources to achieve optimal outcomes, real-world studies, such as the Schizophrenia Care and Assessment Programme (SCAP) contrast with hypothetically based models and provide comprehensive and broad-ranging data.
  
  
  METHODS
  Direct health-care costs were prospectively studied in a cohort of 347 patients with schizophrenia in Dandenong, Australia over 3 years. Indirect costs were estimated from patient self-reported information.
  
  
  RESULTS
  The average annual societal cost was AU $32,160 per participant in the first year of the study, AU $27,190 in the second year and AU $29,181 in the third year. Indirect costs accounted for 46% of the total costs in the first year, 52% of the total costs in the second year and 50% of the total costs in the third year. The most expensive component of treatment was inpatient hospital care, which accounted for 42%, 34% and 36% of the total costs in the first, second and third year, respectively.
  
  
  CONCLUSIONS
  Considerable resources are required for the provision of treatment for patients with schizophrenia. But for the majority of people in this cohort, funding assertive treatment programmes and measures to reduce hospitalization was accompanied with enhanced functioning and quality of life, as well as a reduction in long-term societal and government costs. The distribution of health-care costs is highly skewed, with a relatively small proportion of patients (39%) consuming the majority of resources (80%). Improving rates of employment for this patient group could hold substantial benefits in reducing the overall economic and personal impact of this disorder.
authors.affiliation: Alfred Psychiatry Research Centre, Monash University School of Psychology, Psychiatry and Psychological Medicine, Alfred Hospital, Melbourne, VIC, Australia. paul.fitzgerald@med.monash.edu.au
authors.forename: Paul B
authors.initials: PB
authors.lastname: Fitzgerald
authors.forename: William
authors.initials: W
authors.lastname: Montgomery
authors.forename: Anthony R
authors.initials: AR
authors.lastname: de Castella
authors.forename: Kate M
authors.initials: KM
authors.lastname: Filia
authors.forename: Sacha L
authors.initials: SL
authors.lastname: Filia
authors.forename: Laura
authors.initials: L
authors.lastname: Christova
authors.forename: Dan
authors.initials: D
authors.lastname: Jackson
authors.forename: Jayashri
authors.initials: J
authors.lastname: Kulkarni
mesh_terms: D014150:Antipsychotic Agents / Q000191:economics / Q000627:therapeutic use; D001315:Australia; D003156:Community Mental Health Services / Q000191:economics; D017281:Cost of Illness; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D010045:Outpatients / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D014186:Transportation / Q000191:economics