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Abstract
Schizophrenia is an expensive illness, with hospitalization representing a major cost
of treatment. To evaluate new drugs and management strategies for schizophrenia, we
must have reliable measures of outcomes and costs. Cost-outcome evaluations are particularly
important because they allow comparisons of the potential costs and consequences of
various strategies. The best estimates of outcome use batteries of instruments to
score the well-being of patients and their caregivers. Dimensions of well-being include
clinical status, functional status, access to resources and opportunities, subjective
quality of life, family well-being, and patient satisfaction with services. The best
overall outcome may involve trade-offs between different dimensions (eg, moving a
patient from hospital-based care to community-based care may improve the patient's
quality of life but increase family burden). Although measuring direct costs of schizophrenia
is reasonably straightforward, indirect costs are more difficult to measure. The cost
of pain and suffering (intangible costs) caused by schizophrenia for an individual
patient or family is seldom assessed, although quality-of-life measures may provide
some information. Increased costs of treatments in one area (eg, medication) may well
be offset by reduced expenditures in another (eg, hospitalization). Trade-offs between
different dimensions and different schizophrenia management agencies are only possible
once the boundaries between these have been made clear by proper economic evaluations
Keywords
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© 1997 Published by Elsevier Inc.
