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Which community care for patients with schizophrenic disorders? Packages of Care provided by Departments of Mental Health in Lombardy (Italy)

Published online by Cambridge University Press:  18 May 2011

Antonio Lora ,
Ugo Cosentino ,
Anna Gandini  and
Carlo Zocchetti
Antonio Lora*
Affiliation:
Health Care Directorate, Lombardy Region, Milano
Ugo Cosentino
Affiliation:
Environmental Science Department, University of Milano-Bicocca, Milano
Anna Gandini
Affiliation:
Health Care Directorate, Lombardy Region, Milano
Carlo Zocchetti
Affiliation:
Health Care Directorate, Lombardy Region, Milano
*
Address for correspondence: Dr. A. Lora, Unità Organizzativa: Servizi Sanitari Territoriali, Struttura: Psichiatria e Neuropsichiatria Infantile, Direzione Generale Sanità, Regione Lombardia, Via Pola 9/11, 20124 Milano (Italy). E-mail: antoniolora@virgilio.it
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Summary

Aims – The treatment of schizophrenic disorders is the most important challenge for community care. The analysis focuses on packages of care provided to 23.602 patients with a ICD-10 diagnosis of schizophrenic disorder and treated in 2001 by the Departments of Mental Health in Lombardy, Italy. Methods – Packages of care refer to a mix of treatments provided to each patient during the year by different settings. Direct costs of the packages were calculated. Linear Discriminant Analysis has been used to link socio-demographic and diagnostic sub-groups of the patients to packages of care. Results – People with schizophrenic disorders received relatively few care packages: only four packages involved more than 5%. Two thirds of the patients received only care provided by Community Mental Health Centres. In the other two packages with a percentage over 5%, the activity was provided by CMHCs, jointly with General Hospitals or Day Care Facilities. Complex care packages were rare (only 6%). As well as the intensity, also the variety of care provided by CMHCs increased with the complexity of care packages. In Lombardy more than half of the resources were spent for schizophrenia. The range of the costs per package was very wide. LDA failed to link characteristics of the patients to packages of care. Conclusions – Care packages are useful tools to understand better how mental health system works, how resources have been spent and to point out problems in the quality of care.

Declaration of Interest: None.

Keywords

schizophrenic disorderspattern of carecommunity caredirect costs
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 16 , Issue 4 , December 2007 , pp. 330 - 338
Copyright
Copyright © Cambridge University Press 2007

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