Introduction: Bipolar disorder (BPD) is an affective condition, during which an individual experiences phases of excitement (mania or hypomania) and depression. Type I BPD is characterised by one or more maniac episodes and one or few depressive episodes, whereas type II by different depressive episodes and at least one hypomaniac episode. Bipolar disorder affects approximately 1% of the adult population. There are few studies on treatment costs of BPD in Europe and none in Italy. Objective: This article examines the costs of a sample of 107 BP patients (>18 years) on treatment after an acute episode, for a period of 24 months. The main purpose is to quantify the treatment costs and to explain the causes of variation. Methods: Data on patient profiles and consumption of psychiatric services were collected retrospectively in 12 Italian centres. The costs per patient were calculated by applying unit costs, derived from a previous study on 10 psychiatric departments in Lombardy, to services used. Only direct costs of public psychiatric services (SSN) are considered. Results: The mean age is 46.2 years and was 32.5 years at first BPD diagnosis. About 2/3 of patients are affected by type I BPD, 19% by type II and 10% by unspecified BPD. Out of total, 93.5% reported a new episode, 44% of which was depression, 27% hypomania and 27% mania. All patients were prescribed class N drugs and had a psychiatric visit, while 42% were also hospitalised. The drug treatment covered an average period of 624 days. The mean cost per BP patient is € 9,681 (SD 8,825); hospitalisation is 45% of all costs, whereas drugs are 20% and psychiatric visits 19%. Costs increase according to intensity of care and setting: from € 3,521 for patients treated in community services to € 13,200 in hospitals and to € 28,853 in residential facilities. Treatment costs are not related to age, gender, diagnosis, years since first diagnosis, number and length of acute episodes, but vary significantly with location of psychiatric centres (r = -0,21 from North to South) and type of care pathways (r=0,61). Why different treatment paths, for similar patients, are chosen remains to be explained.
|Titolo:||I costi di trattamento del disturbo bipolare|
MAPELLI, VITTORIO (Primo)
|Parole Chiave:||disturbo bipolare ; costi, utilizzo prestazioni ; farmaci|
|Settore Scientifico Disciplinare:||Settore SECS-P/02 - Politica Economica|
|Data di pubblicazione:||2005|
|Appare nelle tipologie:||01 - Articolo su periodico|