ICAP. An interview for collecting data for the evaluation of psychiatric care costs

Mental health care financing in Italy: current situation and perspectives

Through a review of the studies conducted on the analysis of the costs of the Italian mental health provision of care, this study aimed at describing the current financing system for mental health care in Italy. From the deinstitutionalization to the present days, Italian mental health care financing has evolved in line with both national plans and the actual European directives. The description of the current situation of mental health care financing in Italy can be useful to inform service planning and resource allocation, and to offer a wider European perspective.

What happens to patients seen only once by psychiatric services? Findings from a follow-up study

The aim of this study was to identify patient characteristics associated with once-only contact with a community-based mental health service (CMHS) and to re-evaluate these patients 3 months after the contact. A 33-month cohort of new episodes of care was followed up to identify and interview once-only contact patients. Of the 1101 patients who met the study criteria, 165 (15%) were discharged after the first contact, 87 (8%) dropped out after the first contact, 440 (40%) were low users and 409 (37%) were high users of the CMHS in the 90 days after the first contact. A higher score on the Global Assessment of Functioning scale, less severe psychiatric diagnoses and lower socioeconomic status were the factors most associated with once-only contact at baseline. At follow-up clinical conditions of patients who had only one contact (both discharged patients and drop-outs) had improved and, in most cases, they were in contact with other services. Drop-out patients, however, were more unwell and less satisfied with the initial contact. This dissatisfaction may have led these patients to seek help elsewhere. It is possible that some of these extremely low users are in need of a different or more specialized clinical treatment approach.

Which factors affect the costs of psychiatric residential care? Findings from the Italian PROGRES study

In the latest years, mental hospitals have gradually been replaced by a community-based network of facilities, including non-hospital residential facilities (RFs). Little information is still available about their costs. Our aims were to estimate the costs of Italian RFs and to evaluate which factors affect the cost of RFs and their patients.

METHOD

A representative sample of 265 Italian RFs, hosting 2962 patients, was selected for the study. RFs costs and costs of psychiatric, medical and informal care were estimated.

RESULTS

Patients in RFs cost between 7851 and 34 650 US$ per year; to this amount, it should be added from 2032 to 4702 US$ per year for the community psychiatric services (CPS). Significant differences were found by facility type, geographical areas, number of beds and age and diagnosis. About 45% of the variability for RF costs and 19% for CPS costs was explained by the regression models.

CONCLUSION

The results can be useful to inform service planning and resource allocation.