UTILIZATION AND COST OF PROFESSIONAL CARE AND ASSISTANCE ACCORDING TODISABILITY OF PATIENTS WITH MULTIPLE-SCLEROSIS IN FLANDERS (BELGIUM)

Objectives-To assess the utilisation of medical services and social (c ommunity) assistance in patients with multiple sclerosis of different disability and to calculate the direct healthcare costs to society. Me thods-(1) One hundred and eighty four patients with multiple sclerosis were classified into four grades of disability according to a simplif ied Kurzke disability status scale. (2) Patients were interviewed with a structured questionnaire containing questions on their sociodemogra phic status, the use of inpatient and outpatient medical services and pharmaceutical products during the previous year, the use of social as sistance, and the purchase of prosthetics and charges for house adapta tions during the previous five years. (3) Data were also prospectively collected by means of four week diary annotations of all medical and social acts and their duration. Results-After correction for the disab ility distribution the yearly costs for the 5500 patients with multipl e sclerosis in Flanders was estimated to be ECU 13 106 000 for ambulat ory care including rehabilitation and district nursing and ECU 3 234 0 00 for pharmaceutical products. To these direct medical costs ECU 3 49 1 000 for social assistance and ECU 4 938 000 for prosthetics and adap tations should be added. The yearly costs for admissions to hospital i ncluding permanent residence in an institution and pharmacy was ECU 26 581 000. Home nursing and long term or permanent residence in an inst itution of the most severely disabled, 17% of the multiple sclerosis p opulation, are responsible for 50% of the total direct healthcare cost s and care for the 6.5% institutionalised patients accounts for 23%. D irect costs for medical care and social assistance for patients with m ultiple sclerosis, who account for about 0.1% of the total population, amounts to 1% of the total healthcare budget in Flanders. Conclusion- This information on utilisation of medical services and social assista nce can be used for good healthcare planning and cost effectiveness st udies.