Cost to ambulatory care for schizophrenia in Family Medicine
Keywords:
Schizophrenia, Family Practice, Mental Disorder, Cost of Illness, Health Care CostsAbstract
Background: The groups related to ambulatory care (GRAA, according to its initials in Spanish) are a classification of clinical diagnoses performed on patients receiving medical care in primary care; it is a comprehensive treatment for one year.
Objective: To determine the costs of ambulatory care and sociodemographic characteristics of patients with schizophrenia attended in Family Medicine (FM).
Material and methods: Cross-sectional study which included adult patients with complete electronic clinical record, who had confirmed diagnosis of schizophrenia and received medical attention in a FM unit from January to December 2017. The variables were: age, sex, sociodemographic data, drug addiction and employment status. To determine the annual cost of schizophrenia based on GRAA, the economic medical card was applied, which includes family medicine consultations, inter-consultations, medications, medical supplies, and the time of use of installed capacity for one year.
Results: Out of all patients, 56.2% were men (n = 172). Age was 48.42 ± 14.4 years. Of women, 21.2% were married and 21.2% homemakers, 4.2% smokers, and 1.3% alcohol drinkers. Of men, 30.4% were unmarried, 15% unemployed, 13.1% smokers, and 6.9% alcohol drinkers. The total annual cost of schizophrenia for FGRAA-MH for men was $ 7 613 236.00.
Conclusions: The use of FGRAA-MH revealed the total annual cost for the care of schizophrenia in the medical unit, which provides important information for better understanding the magnitude of this health problem in that area, and will improve planning and economic medical management.
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References
Kovács G, Almási T, Millier A, Toumi M, Horváth M, Kóczián K, et al. Direct healthcare cost of schizophrenia – European overview. Eur Psychiatry. 2018;48:79-92. doi: 10.1016/j.eurpsy.2017.10.008.
Godwin D, Ji A, Kandala S, Mamah D. Functional Connectivity of Cognitive Brain Networks in Schizophrenia during a Working Memory Task. Front Psychiatry. 2017;8:294. doi: 10.3389/fpsyt.2017.00294.
Dauvermann MR, Moorhead TW, Watson AR, Duff B, Romaniuk L, Hall J, et al. Verbal working memory and functional large-scale networks in schizophrenia. Psychiatry Res Neuroimaging. 2017 Dec 30;270:86-96. doi: 10.1016/j.pscychresns.2017.10.004.
Quitian-Reyes H, Arciniegas-Barrera JA, Bohórquez-Peñaranda A, Gómez- Restrepo C. Costo efectividad de los antipsicóticos en el tratamiento de mantenimiento de la esquizofrenia en Colombia. Rev Colomb Psiquiatr. 2016;45(2):67-74.
Díaz-Castro L, Cabello-Rangel H, Arredondo A, Madrigal-de León E, Pineda-Antúnez C. Cost-effectiveness of therapeutic interventions in schizophrenia. Eur J Psychiatry. 2017;31(1):11-6. Disponible en https://www.sciencedirect.com/science/article/pii/S0213616316300179?via%3Dihub [Consultado el 6 de julio de 2018].
Zapata-Ospina JP, Martinez-Villalba AMR, Garcia-Valencia J. Psicoeducación en esquizofrenia. Rev Colomb Psiquiatr. 2015;44(3):143-9.
Ayala L, Sauer T, Ulloa RE. Is a guideline based treatment cost-effective for a middle income country? Results from a study with Mexican adolescents. Schizophr Res. 2018;192:485-6. Disponible en https://www.sciencedirect.com/science/article/pii/S0920996417303316?via%3Dihub [Consultado el 27 de mayo de 2018].
Lara-Muñoz MC, Robles-García R, Orozco R, Real T, Chisholm D, Medina-Mora ME. Estudio de costo-efectividad del tratamiento de la depresión en México. Salud Mental. 2010;33(4):301-8.
Arredondo A, Díaz-Castro L, Cabello-Rangel H, Arredondo P, Recaman AL. Análisis de costos de atención médica para esquizofrenia y depresión en México para el periodo 2005-2013. Cad Saude Publica. 2018;34(1):1-13. Disponible en http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2018000105015&lng=es&tlng=es [Consultado el 19 de julio de 2018].
Echeverría-Zuno S, Arroyave-Loaiza MG, Rodríguez-Díaz MA, Dávila-Torres J. Grupos Relacionados con la Atención Ambulatoria de Salud Mental (GRAA-SM). Primera Ed. México: Instituto Mexicano del Seguro Social; 2012. pp. 1-62.
Organización Mundial de la Salud. Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud (CIE-10). Décima revisión. Ginebra, Suiza: Organización Mundial de la Salud; 1995 (554). Disponible en www.iris.paho.org/xmlui/bitstream/handle/123456789/6282/Volume1.pdf [Consultado el 23 de julio de 2018].
Brostedt EM, Msghina M, Persson M, Wettermark B. Health care use, drug treatment and comorbidity in patients with schizophrenia or non-affective psychosis in Sweden: A cross-sectional study. BMC Psychiatry. 2017;17(1):1-10.
Islek D, Kilic B, Akdede BB. Out-of-pocket health expenditures in patients with bipolar disorder, anxiety, schizophrenia and other psychotic disorders: findings from a study in a psychiatry outpatient clinic in Turkey. Soc Psychiatry Psychiatr Epidemiol. 2018; 53(2):151-60. Disponible en https://link.springer.com/article/10.1007%2Fs00127-017-1465-y [Consultado el 22 de julio de 2018].
Flannery RB, Wyshak G, Flannery GJ. Characteristics of International Assaultive Psychiatric Patients: Review of Published Findings, 2013-2017. Psychiatr Q. 2017;1-9.
Khan A, Iqbal Z, Sultan SM, Nazar Z, Tariq M. Antipsychotic prescription patterns and treatment costs of schizophrenia in Northwestern Pakistan: A one-year observational study. Trop J Pharm Res. 2018;17(2):339-44.
Westcott C, Waghorn G, Mclean D, Statham D, Mowry B. Correlates of employment interest among adults with schizophrenia. Int J Ther Rehabil. 2017;24(12):510-9.
Fresán A, Robles-García R, Madrigal E, Tovilla-Zárate CA, Martínez-López N, Arango de Montis I. Demographic and clinical features related to perceived discrimination in schizophrenia. Psychiatry Res. 2018;262:427-30. Disponible en https://www.sciencedirect.com/science/article/pii/S0165178117303141?via%3Dihub [Consultado el 7 de junio de 2018].
Alosaimi FD, Abalhassan M, Alhaddad B, Fallata EO, Alhabbad A, Alshenqiti R, et al. Gender differences and risk factors for smoking among patients with various psychiatric disorders in Saudi Arabia: a cross-sectional study. Int J Ment Health Syst. 2018;12:21. Disponible en https://ijmhs.biomedcentral.com/articles/10.1186/s13033-018-0201-7 [Consultado el 30 de julio de 2018].
Severi E, Ferrara M, Tedeschini E, Vacca F, Mungai F, Amendolara R, et al. Assessment of cardiovascular risk in an Italian psychiatric outpatient sample: A chart review of patients treated with second-generation antipsychotics. Int J Ment Health Nurs. 2017;1-7.
Subramaniam M, Mahesh MV, Peh CX, Tan J, Fauziana R, Satghare P, et al. Hazardous alcohol use among patients with schizophrenia and depression. Alcohol. 2017;65:63–9. Disponible en https://www.sciencedirect.com/science/article/pii/S0741832916302828?via%3Dihub [Consultado el 11 de junio de 2018].
Medina-Mora ME, Borges, Lara-Muñoz C, Benjet C, Blanco-Jaimes J, Fleiz-Bautista C et al. Prevalencia de Trastornos Mentales y Uso de Servicios: Resultados de la Encuesta Nacional de Epidemiología Psiquiátrica en México. Salud Ment. 2003;26(4):6-14. Disponible en http://revistasaludmental.mx/index.php/salud_mental/article/view/956/954
Consejo Nacional de Población. República Mexicana: Indicadores demográficos 2010-2050, México. México, CONAPO; 2017.
Escotto-Morett J, Ángeles-Llerenas A, Domínguez-Esponda R, Márquez-Caraveo ME. Procesos de atención a menores de 20 años en La Castañeda: Evolución del concepto de infancia en psiquiatría. Salud Publica Mex. 2017;59(4):468-76.
Yan T, Greene M, Chang E, Hartry A, Touya M, Broder MS. All-cause hospitalization and associated costs in patients with schizophrenia or bipolar disorder initiating long-acting injectable antipsychotics. Curr Med Res Opin. 2018;34(1):41-7.
Zeidler J, Slawik L, Fleischmann J, Greiner W. The costs of schizophrenia and predictors of hospitalisation from the statutory health insurance perspective. Health Econ Rev. 2012;2(1):1-8. Disponible en https://healtheconomicsreview.biomedcentral.com/articles/10.1186/2191-1991-2-9 [Consultado el 22 de abril de 2018].
World Health Organization. Mental Health Evidence, Research Team and DCPP. Disease control priorities related to mental, neurological, developmental and substance abuse disorders. Geneva: WHO; 2006.
Jin H, Mosweu I. The Societal Cost of Schizophrenia: A Systematic Review. Pharmacoeconomics. 2017;35(1):25-42.
Medina-Mora ME, Borges G, Lara C, Benjet C, Blanco J, Fleiz C, et al. Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: Results from the Mexican National Comorbidity Survey. Psychol Med. 2005;35(12):1773-83.
Cabello-Rangel H, Díaz-Castro L, Arredondo A. Costo-efectividad de intervenciones para esquizofrenia en México. Salud Ment. 2011;34(2):95-102. Disponible en http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252011000200002 [Citado el 14 de junio de 2018].
Arredondo A, Ramos R, Zúñiga A. Evaluación económica de la demanda de atención médica para salud mental en México: esquizofrenia y depresión, 1996-2000. Rev Investig Clin. 2003;55(1):43-50. Disponible en http://yaqui.mxl.uabc.mx/~larredondo/Documentacion/SaludMental.pdf [Consultado el 18 de abril de 2018].
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