Utilization and Cost of Health Care Services During the First Episode of Psychosis.
Because of the chronicity, severity, and marked psychosocial impairment that may characterize the illness, schizophrenia is an incredibly costly disease. Recent data indicate that intervention earlier in the course of schizophrenia produces cost savings. This study compared health service utilization and associated costs for patients receiving treatment for first-episode psychosis (FEP) delivered within the early-intervention (EI) model at the Prevention and Recovery Center for Early Psychosis (PARC) and for a matched sample of FEP patients receiving treatment as usual at a geographically similar mental health clinic.



This study was a retrospective assessment of 76 PARC patients and 75 patients receiving treatment as usual who were matched by age, race, sex, and diagnosis. Clinical and health service utilization data were extracted from the Midtown and Regenstrief Medical Record Systems, and differences between demographic variables, health service utilization, and cost of services were compared.



Although individuals at PARC had higher physician and nurse visit costs, these were offset by a decrease in costs for acute service utilization. The PARC cohort did not show any difference from the comparison group in terms of total outpatient clinic services used and had fewer inpatient, psychiatric crisis, and emergency room services. Cost analyses reflected a total estimated savings of just over $6,900 per patient.



These findings indicate not only that EI results in cost savings but that increasing medical services may be key in reducing the use of acute services, presumably because of a reduction in psychiatric and general medical pathology.
When this work was completed, Dr. Liffick was with the Department of Psychiatry, Indiana University School of Medicine, Indianapolis (e-mail: eliffick@iupui.edu ), where the other authors are affiliated. She remains affiliated with the department and is also currently with the Department of Global Patient Safety Medical and Benefit-Risk Management, Eli Lilly and Company, Indianapolis.
Emily
E
Liffick
When this work was completed, Dr. Liffick was with the Department of Psychiatry, Indiana University School of Medicine, Indianapolis (e-mail: eliffick@iupui.edu ), where the other authors are affiliated. She remains affiliated with the department and is also currently with the Department of Global Patient Safety Medical and Benefit-Risk Management, Eli Lilly and Company, Indianapolis.
Nicole F
NF
Mehdiyoun
When this work was completed, Dr. Liffick was with the Department of Psychiatry, Indiana University School of Medicine, Indianapolis (e-mail: eliffick@iupui.edu ), where the other authors are affiliated. She remains affiliated with the department and is also currently with the Department of Global Patient Safety Medical and Benefit-Risk Management, Eli Lilly and Company, Indianapolis.
Jenifer L
JL
Vohs
When this work was completed, Dr. Liffick was with the Department of Psychiatry, Indiana University School of Medicine, Indianapolis (e-mail: eliffick@iupui.edu ), where the other authors are affiliated. She remains affiliated with the department and is also currently with the Department of Global Patient Safety Medical and Benefit-Risk Management, Eli Lilly and Company, Indianapolis.
Michael M
MM
Francis
When this work was completed, Dr. Liffick was with the Department of Psychiatry, Indiana University School of Medicine, Indianapolis (e-mail: eliffick@iupui.edu ), where the other authors are affiliated. She remains affiliated with the department and is also currently with the Department of Global Patient Safety Medical and Benefit-Risk Management, Eli Lilly and Company, Indianapolis.
Alan
A
Breier
D000328:Adult; D015331:Cohort Studies; D061345:Early Medical Intervention / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000191:economics / Q000628:therapy; D055815:Young Adult
Cost comparison; Mental Health Services; Psychoses; Schizophrenia; Service delivery systems