[Health service costs in people with severe mental illness: patient report vs. administrative records].
OBJECTIVE
During the last years, self-reported measures of mental health service use for people with mental illness have become increasingly popular. Yet, little is known about the differences between patient report and administrative records and how these may be explained.


METHODS
82 of the 294 participants of the study "Outcome monitoring and outcome management in in-patient psychiatric care" were insured with a major statutory health insurance (AOK Schwaben) and gave informed consent to researchers to access their AOK administrative records. For a 6-month period prior to psychiatric hospital admission, these were compared to the costs as assessed via the German version of the "Client Sociodemographic and Service Receipt Inventory" (CSSRI-EU).


RESULTS
Median total monthly treatment costs were 112.23 € (patient-reported) vs. 254.23 € (administrative records; paired Wilcoxon Z = - 3.75; p < 0.001). Cost differences were independent of participants' socioeconomic and clinical characteristics. Correspondence between total treatment costs was substantial for total costs (ρ = 0.48; p < 0.001) and all subtypes of costs (in- and outpatient services, medication).


CONCLUSIONS
Despite a general tendency to underreport service use, self-report data adequately reflect the "real" health service costs as evident in the health insurance records of people with mental illness.
Klinik für Psychiatrie und Psychotherapie II der Universität Ulm, Bezirkskrankenhaus Günzburg.
Nadja
N
Zentner
Ildiko
I
Baumgartner
Thomas
T
Becker
Bernd
B
Puschner
D000328:Adult; D016527:Drug Costs; D005260:Female; D005858:Germany; D005102:Health Expenditures; D017721:Hospital Costs; D006753:Hospital Records; D006801:Humans; D007358:Insurance, Psychiatric / Q000191:economics; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D012650:Self Disclosure; D014600:Utilization Review / Q000706:statistics & numerical data