Schizophrenia in the Netherlands: Continuity of Care with Better Quality of Care for Less Medical Costs.
BACKGROUND
Patients with schizophrenia need continuous elective medical care which includes psychiatric treatment, antipsychotic medication and somatic health care. The objective of this study is to assess whether continuous elective psychiatric is associated with less health care costs due to less inpatient treatment.


METHODS
Data concerning antipsychotic medication and psychiatric and somatic health care of patients with schizophrenia in the claims data of Agis Health Insurance were collected over 2008-2011 in the Netherlands. Included were 7,392 patients under 70 years of age with schizophrenia in 2008, insured during the whole period. We assessed the relationship between continuous elective psychiatric care and the outcome measures: acute treatment events, psychiatric hospitalization, somatic care and health care costs.


RESULTS
Continuous elective psychiatric care was accessed by 73% of the patients during the entire three year follow-up period. These patients received mostly outpatient care and accessed more somatic care, at a total cost of €36,485 in three years, than those without continuous care. In the groups accessing fewer or no years of elective care 34%-68% had inpatient care and acute treatment events, while accessing less somatic care at average total costs of medical care from €33,284 to €64,509.


CONCLUSIONS
Continuous elective mental and somatic care for 73% of the patients with schizophrenia showed better quality of care at lower costs. Providing continuous elective care to the remaining patients may improve health while reducing acute illness episodes.
Kenniscentrum, Zilveren Kruis Achmea, Leusden, The Netherlands.|Department of Psychiatry, VUmc University Medical Center and GGZIngeest, Amsterdam, The Netherlands.
Arnold
A
van der Lee
Department of Psychiatry, Academic Medical Centre, UvA, Amsterdam, The Netherlands.
Lieuwe
L
de Haan
Department of Psychiatry, VUmc University Medical Center and GGZIngeest, Amsterdam, The Netherlands.
Aartjan
A
Beekman
D000328:Adult; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011787:Quality of Health Care / Q000191:economics*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000191:economics / Q000628:therapy