A systematic review of the indirect costs of schizophrenia in Europe.

Background: Schizophrenia is a chronic disease associated with significant and long-lasting effects on health, and it is also a social and financial burden, not only for patients but also for families, other caregivers, and the wider society. It is essential to conduct the assessment of indirect costs, to understand all the effects of the disease on society. Our aim is to gain a better understanding of the indirect costs of schizophrenia in Europe. Methods: We conducted a comprehensive systematic literature review covering EMBASE, Medline, and PsycINFO as well as reviewing Health Technology Assessment databases from different countries. We used a qualitative research synthesis for presenting information, as most of the studies were methodologically diverse, a quantitative analysis would have been impractical. Results: Indirect cost adjusted to inflation ranged vastly between studies included in the review from 119 Euros to 62, 034 Euros annually. The average proportion of indirect costs of total costs was 44%. Studies highlighted important cost drivers as age, gender, and disease severity, explaining the variation in costs between treatment and patient groups. Conclusions: Regardless of the methodological heterogeneity of the reviewed studies, there was an agreement about the significance of indirect costs of schizophrenia on the society. Considering the relatively high prevalence of schizophrenia in Europe, a need for more cost of illness studies especially from Central Eastern and Southern Europe is suggested.

[What is the difference between patients with and without complex postoperative acute pain therapy?: An analysis of medical and economic characteristics]. / Worin unterscheiden sich Patienten mit und ohne komplexe postoperative Akutschmerztherapie?: Eine Analyse medizinischer und ökonomischer Charakteristika.

BACKGROUND: Appropriate postoperative pain therapy is essential for an accelerated recovery. However, coding complex acute pain therapy (OPS 8-919) does not have any impact on hospital revenues. As medical and economic primary data related to this therapy are scarce, hospital data were analysed to identify differences between patients with and without acute pain therapy. MATERIAL AND METHODS: Two patient groups were generated out of an anonymized data set from 372 acute care hospitals in 2005: The case group (G1) included 4,197 patients (OPS 8-919 coded). The control group (G2) contained 61,181 patients (neither OPS 8-919 nor 8-910 nor 8-911 coded). RESULTS: The analysis revealed that patients in G1 had a prolonged mean length of hospital stay (2.5 days). The mean number of diagnoses per case was similar in both groups (G1:6.9, G2:6.6), whereas the mean number of procedures was higher in G1 (G1:8.2, G2:6.2). The difference in mean diagnosis-related group (DRG) revenue per case was about EUR 200 (G1:EUR 9,233, G2:EUR 9,030). CONCLUSION: To validate the results found in this analysis, further evaluations of these patient groups are essential. High-quality documentation and coding in hospitals are required for future studies.