Some aspects of the cost of schizophrenia in France.

This study aimed to investigate how patients with schizophrenia were treated and to evaluate the cost of treatment in medical and social terms in France. The study was questionnaire-based. 6000 French hospital and community psychiatrists in the public and private sectors received the questionnaire. The 494 psychiatrists who responded described the treatment prescribed for, and social assistance provided to, the last patient consulting for schizophrenia-as defined by the criteria of the third edition (revised) of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R)-either as an outpatient or as an impatient in the last year. The clinical, epidemiological and therapeutic data collected on 356 (72%) patients receiving outpatient treatment and 138 (28%) patients receiving impatient treatment in the public (242 patients; 49%) or private (252 patients; 51%) sectors were processed by medical and economic modelling. The mean (+/-standard deviation) time from symptom onset to study entry was 11 +/- 8 years, while the mean time from first hospital admission to study entry was 9.5 +/- 8 years. The mean time from symptom onset to initial hospitalisation was 25 +/- 4 months. 224 patients had been hospitalised in a psychiatric ward at least once in the previous year (45%). The average duration of hospitalisation was 82 +/- 96 days. During the year of the study, 122 patients received part-time treatment in a day hospital or intermediate facility (e.g. occupational therapy centres, therapeutic workshops and therapeutic apartments), 39 (8%) on a daily basis and 83 (17%) one or more times a week; medical care lasted 130 +/- 137 days and 107 +/- 89 days, respectively. The annual complete cost of medical management of the 477 evaluable patients in the study was F27471511 (1992 values). The overall annual treatment cost (medical and social) was F1533724 for medication (5.6% of the complete cost), F2600673 for visits (9.5%), F8285900 for intermediate facilities (30.1%) and F15051214 (54.8%) for hospitalisation. The social allowance cost was F10926000. The average annual costs of medical care and social allowance per patient with schizophrenia were respectively estimated at F54970 and F22905. The annual cost of medical management of schizophrenia in France was thus F12.37 billion ($US2.34 billion).