title: Direct medical costs associated with schizophrenia relapses in health care services in the city of São Paulo.
abstract: OBJECTIVE
  To assess direct medical costs associated with schizophrenia relapses in mental health services.
  
  
  METHODS
  The study was conducted in three health facilities in the city of São Paulo: a public state hospital; a Brazilian National Health System (SUS)-contracted hospital; and a community mental health center. Medical records of 90 patients with schizophrenia who received care in 2006 were reviewed. Information on inpatient expenditures was collected and used for cost estimates.
  
  
  RESULTS
  Mean direct medical cost of schizophrenia relapses per patient was US$ 4,083.50 (R$ 8,167.58) in the public state hospital; US$ 2,302.76 (R$ 4,605.46) in the community mental health center; and US$ 1,198.50 (R$ 2,397.74) in the SUS-affiliated hospital. The main component was daily inpatient room rates (87% - 98%). Medication costs varied depending on the use of typical or atypical antipsychotic drugs. Atypical antipsychotic drugs were more often used in the community mental health center.
  
  
  CONCLUSIONS
  Costs associated with schizophrenia relapses support investments in antipsychotic drugs and strategies to reduce disease relapse and the need for mental health inpatient services. Treating patients in a community mental health center was associated with medium costs and added the benefit of not depriving these patients from family life.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil. csdaltio@yahoo.com
authors.forename: Claudiane Salles
authors.initials: CS
authors.lastname: Daltio
authors.forename: Jair Jesus
authors.initials: JJ
authors.lastname: Mari
authors.forename: Marcos Bosi
authors.initials: MB
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D004180:Direct Service Costs; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008605:Mental Health Services / Q000145:classification / Q000191:economics*; D008875:Middle Aged; D012008:Recurrence; D012559:Schizophrenia / Q000191:economics*; D055815:Young Adult