Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.
Rev Saude Publica. 2011 Feb;45(1):14-23. doi: 10.1590/s0034-89102010005000049. Epub 2010 Nov 12.
To assess direct medical costs associated with schizophrenia relapses in mental health services.
The study was conducted in three health facilities in the city of São Paulo: a public state hospital; a Brazilian National Health System (SUS)-contracted hospital; and a community mental health center. Medical records of 90 patients with schizophrenia who received care in 2006 were reviewed. Information on inpatient expenditures was collected and used for cost estimates.
Mean direct medical cost of schizophrenia relapses per patient was US$ 4,083.50 (R$ 8,167.58) in the public state hospital; US$ 2,302.76 (R$ 4,605.46) in the community mental health center; and US$ 1,198.50 (R$ 2,397.74) in the SUS-affiliated hospital. The main component was daily inpatient room rates (87% - 98%). Medication costs varied depending on the use of typical or atypical antipsychotic drugs. Atypical antipsychotic drugs were more often used in the community mental health center.
Costs associated with schizophrenia relapses support investments in antipsychotic drugs and strategies to reduce disease relapse and the need for mental health inpatient services. Treating patients in a community mental health center was associated with medium costs and added the benefit of not depriving these patients from family life.
评估精神卫生服务中精神分裂症复发的直接医疗成本。
该研究在圣保罗市的 3 家医疗机构进行：一家公立州立医院、一家巴西国家卫生系统（SUS）签约医院和一家社区心理健康中心。回顾了 2006 年接受治疗的 90 名精神分裂症患者的医疗记录。收集了住院支出信息，并用于成本估算。
公立州立医院每位精神分裂症复发患者的直接医疗费用平均为 4083.50 美元（8167.58 雷亚尔）；社区心理健康中心为 2302.76 美元（4605.46 雷亚尔）；SUS 附属医院为 1198.50 美元（2397.74 雷亚尔）。主要构成部分是每日住院病房费用（87%-98%）。药物费用取决于使用典型或非典型抗精神病药物。在社区心理健康中心，非典型抗精神病药物的使用更为常见。
精神分裂症复发相关成本支持对抗精神病药物的投资以及减少疾病复发和精神卫生住院服务需求的策略。在社区心理健康中心治疗患者的成本中等，并且为这些患者提供了不剥夺其家庭生活的好处。
