Martin Knapp1, Derek King, Klaus Pugner, Pablo Lapuerta. 1. LSE Health and Social Care, London School of Economics and Political Science, and Centre for the Economics of Mental Health, Institute of Psychiatry, London, UK. M.Knapp@ise.ac.uk
Abstract
BACKGROUND: Several factors are thought to influence resource use and costs in treating schizophrenia. AIMS: To assess the relative impact of non-adherence and other factors associated with resource use and costs incurred by people with schizophrenia. METHOD: Secondary analyses were made of data from a 1994 national survey of psychiatric morbidity among adults living in institutions in the UK. Factors potentially relating to resource use and costs were examined using two-part models. RESULTS: Patients who failed to adhere to their medication regimen were over one-and-a-half times as likely as patients who did adhere to it to report use of in-patient services. Non-adherence is one of the most significant factors in increasing external service costs, by a factor of almost 3. Non-adherence predicted an excess annual cost per patient of approximately 2500 British pounds for in-patient services and over 5000 British pounds for total service use. CONCLUSIONS: Resource use and costs are influenced by various factors. Medication non-adherence consistently exhibits an association with higher costs. Further important factors are patient needs and the ability of the system to address them.
BACKGROUND: Several factors are thought to influence resource use and costs in treating schizophrenia. AIMS: To assess the relative impact of non-adherence and other factors associated with resource use and costs incurred by people with schizophrenia. METHOD: Secondary analyses were made of data from a 1994 national survey of psychiatric morbidity among adults living in institutions in the UK. Factors potentially relating to resource use and costs were examined using two-part models. RESULTS:Patients who failed to adhere to their medication regimen were over one-and-a-half times as likely as patients who did adhere to it to report use of in-patient services. Non-adherence is one of the most significant factors in increasing external service costs, by a factor of almost 3. Non-adherence predicted an excess annual cost per patient of approximately 2500 British pounds for in-patient services and over 5000 British pounds for total service use. CONCLUSIONS: Resource use and costs are influenced by various factors. Medication non-adherence consistently exhibits an association with higher costs. Further important factors are patient needs and the ability of the system to address them.
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