Williams R, Dickson R A
University of Calgary, Alberta.
Can J Psychiatry. 1995 Sep;40(7 Suppl 2):S60-7. doi: 10.1177/070674379504007s06.
To discuss the costs associated with mental illnesses that constitute a significant percentage of the total direct health care costs, currently estimated at $1605 per person per year (9% of the gross national product). The cost of all mental illness in the US has been estimated at US$103.7 billion (1985 dollars), of which schizophrenia alone accounts for US$22.7 billion.
A number of studies that have attempted to evaluate the cost of therapies in schizophrenia are examined.
While schizophrenia affects only 1% of the population, it accounts for 2.5% of total health care expenditures in the US. For first-admission patients suffering from schizophrenia, it would appear to cost less to provide the most clinically-effective treatments than to provide a good level of milieu care with special treatment.
Community-based care can be less costly than conventional hospital-based programs and can improve patient quality of life. Inhospital programs that reduce length of stay with the use of medication clinics or day hospital care may achieve significant cost savings. A special challenge is the subgroup of patients suffering from schizophrenia that is neuroleptic-resistant. New drugs, such as the atypical neuroleptics, clozapine and risperidone, may prove to be highly cost-effective in treating schizophrenia by preventing relapse and reducing hospital lengths of stay.
探讨精神疾病相关成本，精神疾病成本在直接医疗总成本中占很大比例，目前估计为每人每年1605美元（占国民生产总值的9%）。美国所有精神疾病的成本估计为1037亿美元（按1985年美元计算），其中仅精神分裂症就占227亿美元。
对一些试图评估精神分裂症治疗成本的研究进行了审查。
虽然精神分裂症仅影响1%的人口，但它占美国医疗总支出的2.5%。对于首次入院的精神分裂症患者，提供最具临床疗效的治疗似乎比提供高水平的环境护理和特殊治疗成本更低。
基于社区的护理可能比传统的住院治疗项目成本更低，并且可以提高患者的生活质量。通过使用药物治疗诊所或日间医院护理来缩短住院时间的住院项目可能会实现显著的成本节约。一个特殊的挑战是对神经阻滞剂耐药的精神分裂症患者亚组。新型药物，如非典型神经阻滞剂氯氮平和利培酮，通过预防复发和缩短住院时间，可能在治疗精神分裂症方面具有很高的成本效益。
