Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder

• Published in: PloS one Vol. 11; no. 7; p. e0157635
• Main Authors: Hirjak, Dusan, Hochlehnert, Achim, Thomann, Philipp Arthur, Kubera, Katharina Maria, Schnell, Knut
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 08.07.2016; Public Library of Science (PLoS)
• Subjects: Accounting; Adolescent; Adult; Aged; Aged, 80 and over; Analysis; Bipolar disorder; Care and treatment; Cohort Studies; Complications and side effects; Cost analysis; Costs; Disorders; Economic aspects; Electronic Health Records; Emotions; Female; Germany; Hallucinations; Health aspects; Health Care Costs; Humans; Infrastructure; Male; Medical diagnosis; Medicine; Medicine and Health Sciences; Mental disorders; Mental Health Services - economics; Middle Aged; Paranoia; Patients; People and Places; Personnel; Pharmaceuticals; Psychiatry; Psychiatry - economics; Psychophysiologic Disorders - economics; Psychosis; Psychosomatics; Psychotic Disorders - economics; Psychotic Disorders - therapy; Psychotropic drugs; Retrospective Studies; Schizoaffective disorder; Schizophrenia; Schizophrenia, Paranoid - economics; Schizophrenia, Paranoid - therapy; Social Sciences; Statistical analysis; Systematic review; Young Adult; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0157635

Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ) or schizoaffective disorder (SAD), a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system of cost accounting in psychiatry and psychosomatics in Germany assesses all schizophrenia spectrum disorders within one category. The study comprised a retrospective audit of data from 118 patients diagnosed with paranoid SZ (F20.0) and 71 patients with SAD (F25). We used the mean total costs as well as partial cost, i.e., mean costs for medication products, mean personal costs and mean infrastructure costs from each patient for the statistical analysis. We tested for differences in the four variables between SZ and SAD patients using ANCOVA and confirmed the results with bootstrapping. SAD patients had a longer duration of stay than patients with SZ (p = .02). Mean total costs were significantly higher for SAD patients (p = .023). Further, we found a significant difference in mean personnel costs (p = .02) between patients with SZ and SAD. However, we found no significant differences in mean pharmaceutical costs (p = .12) but a marginal difference of mean infrastructure costs (p = .05) between SZ and SAD. We found neither a common decrease of costs over time nor a differential decrease in SZ and SAD. We found evidence for a difference of case related costs of inpatient treatments for paranoid SZ and SAD. The differences in mean total costs seem to be primarily related to the mean personnel costs in patients with paranoid SZ and SAD rather than mean pharmaceutical costs, possibly due to higher personnel effort and infrastructure.