Direct and indirect costs of schizophrenia in community psychiatric services in Italy: The GISIES study

Backround : The present work is a cost-of-illness (COI) study that aims at assessing total direct and indirect costs of schizophrenic patients in community psychiatric services in Italy and identifying the variables that influence costs. Methods :A retrospective prevalence-based multi-centre COI study, was designed. Ten community mental health centres (CMHC) were involved and 100 patients were recruited. Data on patients’ costs were gathered through specifically designed instruments. Results :More than half total direct costs was attributed to CMHC interventions. The yearly average costs of schizophrenia per patient amounted to nearly ITL 50 million: 30% for direct costs and 70% for indirect costs. Conclusion :CMHCs tend to manage long-term ill patients by adopting a strong community-based system of care. Schizophrenia is correlated to loss of working days and lack of well-being. From the resultsof this study, it might be argued that the de-institutionalisation programme has produced ‘spillovers’ in terms of families’ greater involvement in patients management