Understanding the direct and indirect costs of a first episode of psychosis program: Insights from PAFIP of Cantabria, Spain, during the first year of intervention

Abstract

Aim: Early intervention psychiatric services for patients with psychosis aim to limit the most damaging outcomes and reduce the patient's risk of social drift, decreasing illness severity and thus containing healthcare costs. There is a scarcity of studies that focus on first-episode psychosis (FEP), and those few that have been published only looked at direct health costs, but not at indirect costs, which make up the bulk of the budget.Our study aims to explore the short-term (1-year follow-up) economic cost of a FEP Program, including both direct and indirect costs. Methods: Data were collected retrospectively from the clinical records of 157 patients included in the Programa Atención Fases Iniciales de Psicosis, from Marqués de Valdecilla University Hospital, Santander. Our data collection sheet collated data from direct and indirect costs associated with the illness. Data were also extracted from the Cantabria Health Service Records. STATA 15.0 was used for statistical analysis.Results: On average, the total costs during the first year were €48 353.51 per patient, with direct healthcare costs being €13 729.47 (28.39%), direct non-medical costs €108.6 (0.22%), and indirect costs €34 515.44 (71.39%). We found that hospitalization costs were higher in males (p = 0.081) and in cannabis users (p = 0.032). The number of relapses increased both, hospitalization and treatment costs (r = 0.40 p = 0.000; r = 0.24 p = 0.067, respectively).Conclusions: Intensive Early Intervention in Psychosis Services may result in cost savings by decreasing hospitalization, premature mortality, disability, unemployment, and legal problems; however, the first year after diagnosis would represent the one with the highest costs. K E Y W O R D Scosts analysis, early intervention services, first episode psychosis, schizophrenia

Overcoming the gap between child and adult mental health services: The Reggio Emilia experience in an early intervention in psychosis program

“…Moreover, Baumann et al (2013) observed that 8 years after implementation, an EIP program in Lausanne (Switzerland) included 350 young patients (aged 14–25 years) with a disengagement rate of 9% over 3 years of treatment. Finally, Mayoral‐van Son et al (2019) reported that 157 young people with early psychosis (aged 15–25 years) entered a specific EIP program in Cantabria (Spain) during a 1‐year treatment period.…”

Psychosocial interventions for community-dwelling individuals with schizophrenia: study protocol for a systematic review and meta-analysis

“…The accumulating evidence suggests that negative symptoms have more impact on everyday functioning and quality of life than positive and other symptom factors 3 4. Globally, schizophrenia is generally regarded as a low prevalence mental disorder (the global age-standardised point prevalence is 0.28%), but it creates a considerable economic deficit to society due to losses in productivity by individuals, costs for treatment and significant burdens on health and welfare systems 5 6…”

Oral and Palmitate Paliperidone Long-Acting Injectable Formulations’ Use in Schizophrenia Spectrum Disorders: A Retrospective Cohort Study from the First Episode Psychosis Intervention Program (CRUPEP)

“…Failure to achieve remission of symptoms has been associated with the chronicity of the disease and persistent negative symptoms and functional deficits, which are crucial to achieving psychosocial recovery ( Schooler, 2006 ). Chronicity has also been associated with the existence of frequent relapses, a higher burden of principal careers, an impact on direct and indirect costs of the disease, and poorer long-term course outcomes, including those directly associated with the daily psychosocial functioning of patients with an FEP ( Álvarez-Jiménez et al, 2012b ; Mayoral-van Son et al, 2019 ). Hence, functional recovery remains the cornerstone in managing and treating patients with an FEP ( Robinson et al, 2004 ).…”