Cost of schizophrenia in a randomized trial of home-based treatment

A randomized trial of acute psychiatric care was conducted to compare home-based interventions with standard care. The setting of the study was a comprehensive urban psychiatric service in London. Sixteen of the 172 patients in the study had schizophrenia--11 in standard care (SC) and 5 in community care (CC). Care for patients with schizophrenia was, on average, twice as expensive as care for nonschizophrenic patients. This large and statistically significant difference was mainly the result of increased inpatient care, which averaged 33 days for the schizophrenic group compared to 7.6 days for non-schizophrenic patients. There was a modest increase in general practice and outpatient contacts among the schizophrenic patients compared with nonschizophrenic patients, but surprisingly little use of day hospital facilities. The SC schizophrenic care cost nearly twice as much as CC care, but this was not a statistically significant difference. These results suggest that provision of active community services for schizophrenic patients may lead to overall savings in care costs, mainly by a reduction in inpatient stays.