title: Regional variations and determinants of direct psychiatric costs in Sweden.
abstract: OBJECTIVE
  The aim of the present study was to investigate socioeconomic and demographic determinants of direct costs for psychiatric disorders in Sweden. The cost categories were inpatient and outpatient costs, and costs for psychopharmacological drugs. Two consecutive years, 2001 and 2002, were chosen as the study period.
  
  
  METHODS
  The study included all costs for admissions, visits and prescribed drugs for adults aged > or = 18 years in 2001 and 2002 in Sweden. These costs were aggregated and analysed at the county level. A multiple linear regression analysis was fitted to the data, and independent variables (i.e. predictors) were chosen on the basis of previous studies. All cost types (e.g. total, inpatient, outpatient and drug costs) were analysed separately in different models.
  
  
  RESULTS
  Large variations in total direct psychiatric costs were found between county councils (for example, the total costs varied between euro112 and euro195 per capita in 2001). The results indicate that psychiatric outpatient care is less utilized in rural than in urban areas, and drugs are more often prescribed in rural areas than in urban areas. Areas with a high proportion of women and people aged 65 years and over are strong predictors of mental healthcare costs, i.e. variables showing that the higher the proportion, the lower the direct costs.
  
  
  CONCLUSIONS
  Factors such as urbanization, gender, age and number of immigrants are reasons for differences in psychiatric direct costs. On the basis of these findings, it seems plausible to conclude that women, older patients and immigrants may benefit from specialized psychiatry, but that such healthcare does not seem to be provided in all regions.
authors.affiliation: Danderyd Hospital, Psychiatric Clinic, R&D Section, Stockholm, Sweden. anne.tiainen@sll.se
authors.forename: Anne
authors.initials: A
authors.lastname: Tiainen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Edman
authors.forename: Lena
authors.initials: L
authors.lastname: Flyckt
authors.forename: Göran
authors.initials: G
authors.lastname: Tomson
authors.forename: Clas
authors.initials: C
authors.lastname: Rehnberg
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D016527:Drug Costs; D054242:Emigrants and Immigrants; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology / Q000208:ethnology; D008605:Mental Health Services / Q000191:economics*; D008875:Middle Aged; D010045:Outpatients; D011619:Psychotropic Drugs / Q000191:economics; D012042:Registries; D012424:Rural Population; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology / Q000208:ethnology; D014505:Urban Population
chemical_list: D011619:Psychotropic Drugs