Effects of risperidone therapy on the use of mental health care resources in Salt Lake County, Utah.

The authors analyze the use of mental health care resources before and after the initiation of risperidone therapy in patients of Valley Mental Health, an agency providing aggressive community-based treatment in Salt Lake County, Utah. Sixty-three patients were treated with risperidone during the period from February 1994 through June 1995. Data for at least 6 months before (pre-period) and after (post-period) risperidone therapy were available for 61 patients; the mean period for which data were obtained was 31.8 months (pre- plus post-period). Risperidone use was associated with a reduction, albeit nonsignificant, in the numbers of patients requiring acute inpatient hospital care (-29%), days hospitalized (-1 day per year), residential treatment days (-0.7 days per year), and day-treatment visits (-1.7 visits per year), together with small increases, also nonsignificant, in the need for emergency/crisis intervention (0.1 visit per year), outpatient treatment (0.1 visit per year), and case management (2.3 visits per year). The costs of institutional plus ambulatory care declined from $7949 to $6910 per patient per year (-13%); the greatest reduction was in the cost of acute inpatient care (-18%). With the addition of risperidone, the cost of psychotropic medications doubled, resulting in a statistically nonsignificant mean increase in total costs of $305 per patient per year. Among the 36 patients who received risperidone during > or = 70% of the post-period and the 17 patients who had been hospitalized during the pre-period, total costs declined -3% and -13%, respectively. The results confirm those of previous studies and demonstrate that risperidone can reduce the use of mental health services.