The analysis of cost structures of the treatment of schizophrenia by meansof standardized assessment instruments.

Objective: Aims of the study are the analysis oft the structures and influe nce factors causing direct costs of schizophrenic diseases by means of inte rnational standardized assessment instruments. Method: Annual costs of trea tment were assessed for a sample of 258 patients with the diagnosis of schi zophrenia (ICD-10 F20) by means of the German version of the CSSRI. For the analysis of cost variance a regression model was computed using functional level (GAF), symptoms (BPRS 4.0), needs for care (CAN), service satisfacti on (VSSS) and subjective quality of life (LQoLP) as predictors. Results: Th e average yearly treatment costs for the study sample were 12726,- DM. Cost s for sheltered accommodation and for psychiatric inpatient treatment were found to be the largest elements of the entire costs followed by the costs for ambulant medications. Results of the regression analysis show that illn ess history, the severity of symptoms and the need for care explain the gre atest proportion of variance. Conclusions: The standardized instruments dev eloped in the project enable a systematic and international comparable asse ssment of the costs in the treatment of schizophrenic diseases. Furthermore the instruments allow to explain 38% of the cost variance. The impact of t he severity of symptoms under statistical control of the functional impairm ent and the needs for care suggests that an effective reduction of symptoms could lead to savings in the entire treatment costs. However, the great in fluence of the illness history and, irrespective of the functional impairme nt, the need for care show that the possibilities for cost savings in the t reatment of schizophrenia are generally low.