Cost effectiveness of different treatment strategies in schizophrenia outpatient care

In a subproject of the German competence network for schizophrenia, the costs of outpatient care in Munich with and without QM interventions were evaluated for a subsample.

30 psychiatrists in private practices were randomly assigned either to a QM intervention group or a control group (152 and 147 patients resp.). For a randomly selected subsample of 80 patients in each group, the annual direct and indirect costs were prospectively assessed in combination with process and outcome indicators.

Hospital admissions of 11 patients were as expensive as psychiatric outpatient care (pharmaceutical costs and doctors’ fees) for all 160 patients. Medication was only 20% of the direct costs and 6% of all costs. More study patients took advantage of psychosocial services than control patients. The rate of hospitalizations, however, was lower in the study sample.

Evaluations of all patients for 18 months are underway to demonstrate the effect of QM interventions (e. g. medication according to guidelines) with a focus on medication and treatment outcome.