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Published in: BMC Psychiatry 1/2010

Open Access 01-12-2010 | Research article

Pattern of healthcare resource utilization and direct costs associated with manic episodes in Spain

Authors: Monica Tafalla, Luis Salvador-Carulla, Jerónimo Saiz-Ruiz, Teresa Diez, Luis Cordero

Published in: BMC Psychiatry | Issue 1/2010

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Abstract

Background

Although some studies indicate that bipolar disorder causes high health care resources consumption, no study is available addressing a cost estimation of bipolar disorder in Spain. The aim of this observational study was to evaluate healthcare resource utilization and the associated direct cost in patients with manic episodes in the Spanish setting.

Methods

Retrospective descriptive study was carried out in a consecutive sample of patients with a DSM-IV diagnosis of bipolar type I disorder with or without psychotic symptoms, aged 18 years or older, and who were having an active manic episode at the time of inclusion. Information regarding the current manic episode was collected retrospectively from the medical record and patient interview.

Results

Seven hundred and eighty-four evaluable patients, recruited by 182 psychiatrists, were included in the study. The direct cost associated with healthcare resource utilization during the manic episode was high, with a mean cost of nearly €4,500 per patient, of which approximately 55% corresponded to the cost of hospitalization, 30% to the cost of psychopharmacological treatment and 10% to the cost of specialized care.

Conclusions

Our results show the high cost of management of the patient with a manic episode, which is mainly due to hospitalizations. In this regard, any intervention on the management of the manic patient that could reduce the need for hospitalization would have a significant impact on the costs of the disease.
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Literature
1.
go back to reference American Psychiatric Association: Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry. 2002, 159 (4 Suppl): 1-50. American Psychiatric Association: Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry. 2002, 159 (4 Suppl): 1-50.
2.
go back to reference American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (text revision). 2000, Washington, DC, APACrossRef American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (text revision). 2000, Washington, DC, APACrossRef
3.
go back to reference Wittchen HU, Jacobi F: Size and burden of mental disorders in Europe--a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol. 2005, 15: 357-76. 10.1016/j.euroneuro.2005.04.012.CrossRefPubMed Wittchen HU, Jacobi F: Size and burden of mental disorders in Europe--a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol. 2005, 15: 357-76. 10.1016/j.euroneuro.2005.04.012.CrossRefPubMed
4.
go back to reference Criado-Alvarez JJ, Domper Tornil JA, de la Rosa Rodriguez G: Estimación de la prevalencia de trastornos bipolares tipo I en España a través del consumo de carbonato de litio. Rev Esp Salud Publica. 2000, 74: 131-8. 10.1590/S1135-57272000000200004.CrossRefPubMed Criado-Alvarez JJ, Domper Tornil JA, de la Rosa Rodriguez G: Estimación de la prevalencia de trastornos bipolares tipo I en España a través del consumo de carbonato de litio. Rev Esp Salud Publica. 2000, 74: 131-8. 10.1590/S1135-57272000000200004.CrossRefPubMed
5.
go back to reference Murray CJL, Lopez AD, eds: The Global Burden of Disease and Injury Series, Volume 1: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. 1996, Cambridge, Mass: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank; Harvard University Press Murray CJL, Lopez AD, eds: The Global Burden of Disease and Injury Series, Volume 1: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. 1996, Cambridge, Mass: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank; Harvard University Press
6.
go back to reference Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A: No health without mental health. Lancet. 2007, 370: 859-77. 10.1016/S0140-6736(07)61238-0.CrossRefPubMed Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A: No health without mental health. Lancet. 2007, 370: 859-77. 10.1016/S0140-6736(07)61238-0.CrossRefPubMed
7.
go back to reference Pini S, de Queiroz V, Pagnin D, Pezawas L, Angst J, Cassano GB, Wittchen HU: Prevalence and burden of bipolar disorders in European countries. Eur Neuropsychopharmacol. 2005, 15: 425-34. 10.1016/j.euroneuro.2005.04.011.CrossRefPubMed Pini S, de Queiroz V, Pagnin D, Pezawas L, Angst J, Cassano GB, Wittchen HU: Prevalence and burden of bipolar disorders in European countries. Eur Neuropsychopharmacol. 2005, 15: 425-34. 10.1016/j.euroneuro.2005.04.011.CrossRefPubMed
8.
go back to reference Harris E, Barraclough B: Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry. 1997, 170: 205-228. 10.1192/bjp.170.3.205.CrossRefPubMed Harris E, Barraclough B: Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry. 1997, 170: 205-228. 10.1192/bjp.170.3.205.CrossRefPubMed
9.
go back to reference Sharma R, Markar H: Mortality in affective disorder. J Affect Disord. 1994, 31: 91-6. 10.1016/0165-0327(94)90112-0.CrossRefPubMed Sharma R, Markar H: Mortality in affective disorder. J Affect Disord. 1994, 31: 91-6. 10.1016/0165-0327(94)90112-0.CrossRefPubMed
10.
go back to reference Osby U, Brandt L, Correia N, Ekbom A, Sparen P: Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry. 2001, 58: 844-50. 10.1001/archpsyc.58.9.844.CrossRefPubMed Osby U, Brandt L, Correia N, Ekbom A, Sparen P: Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry. 2001, 58: 844-50. 10.1001/archpsyc.58.9.844.CrossRefPubMed
11.
go back to reference Keck PE, McElroy SL, Strakowski SM, West SA, Sax KW, Hawkins JM, Bourne ML, Haggard P: 12-month outcome of patients with bipolar disorder following hospitalization for a manic or mixed episode. Am J Psychiatry. 1998, 155: 646-52.CrossRefPubMed Keck PE, McElroy SL, Strakowski SM, West SA, Sax KW, Hawkins JM, Bourne ML, Haggard P: 12-month outcome of patients with bipolar disorder following hospitalization for a manic or mixed episode. Am J Psychiatry. 1998, 155: 646-52.CrossRefPubMed
12.
go back to reference Dion GL, Tohen M, Anthony WA, Waternaux CS: Symptoms and functioning of patients with bipolar disorder six months after hospitalization. Hosp Community Psychiatry. 1988, 39: 652-7.PubMed Dion GL, Tohen M, Anthony WA, Waternaux CS: Symptoms and functioning of patients with bipolar disorder six months after hospitalization. Hosp Community Psychiatry. 1988, 39: 652-7.PubMed
13.
go back to reference Leidy NK, Palmer C, Murray M, Robb J, Revicki DA: Health-related quality of life assessment in euthymic and depressed patients with bipolar disorder. Psychometric performance of four self-report measures. J Affect Disord. 1998, 48: 207-14. 10.1016/S0165-0327(97)00147-X.CrossRefPubMed Leidy NK, Palmer C, Murray M, Robb J, Revicki DA: Health-related quality of life assessment in euthymic and depressed patients with bipolar disorder. Psychometric performance of four self-report measures. J Affect Disord. 1998, 48: 207-14. 10.1016/S0165-0327(97)00147-X.CrossRefPubMed
14.
go back to reference Dean BB, Gerner D, Gerner RH: A Systematic Review Evaluating Health-Related Quality of Life, Work Impairment, and Healthcare Costs and Utilization in Bipolar Disorder. Curr Med Res Opin. 2004, 20: 139-154. 10.1185/030079903125002801.CrossRefPubMed Dean BB, Gerner D, Gerner RH: A Systematic Review Evaluating Health-Related Quality of Life, Work Impairment, and Healthcare Costs and Utilization in Bipolar Disorder. Curr Med Res Opin. 2004, 20: 139-154. 10.1185/030079903125002801.CrossRefPubMed
15.
go back to reference Andlin-Sobocki P, Wittchen HU: Cost of affective disorders in Europe. European Journal of Neurology. 2005, 12 (S1): 34-8. 10.1111/j.1468-1331.2005.01195.x.CrossRefPubMed Andlin-Sobocki P, Wittchen HU: Cost of affective disorders in Europe. European Journal of Neurology. 2005, 12 (S1): 34-8. 10.1111/j.1468-1331.2005.01195.x.CrossRefPubMed
16.
go back to reference Wyatt RJ, Henter I: An economic evaluation of manic-depressive illness--1991. Soc Psychiatry Psychiatr Epidemiol. 1995, 30: 213-9.PubMedPubMedCentral Wyatt RJ, Henter I: An economic evaluation of manic-depressive illness--1991. Soc Psychiatry Psychiatr Epidemiol. 1995, 30: 213-9.PubMedPubMedCentral
17.
go back to reference Begley CE, Annegers JF, Swann AC, Lewis C, Coan S, Schnapp WB, Bryant-Comstock L: The lifetime cost of bipolar disorder in the US: an estimate for new cases in 1998. Pharmacoeconomics. 2001, 19 (5 Pt 1): 483-95. 10.2165/00019053-200119050-00004.CrossRefPubMed Begley CE, Annegers JF, Swann AC, Lewis C, Coan S, Schnapp WB, Bryant-Comstock L: The lifetime cost of bipolar disorder in the US: an estimate for new cases in 1998. Pharmacoeconomics. 2001, 19 (5 Pt 1): 483-95. 10.2165/00019053-200119050-00004.CrossRefPubMed
18.
go back to reference Guo JJ, Keck PE, Li H, Jang R, Kelton CML: Treatment Costs and Health Care Utilization for Patients with Bipolar Disorder in a Large Managed Care Population. Value Health. 2008, 11: 416-23. 10.1111/j.1524-4733.2007.00287.x.CrossRefPubMed Guo JJ, Keck PE, Li H, Jang R, Kelton CML: Treatment Costs and Health Care Utilization for Patients with Bipolar Disorder in a Large Managed Care Population. Value Health. 2008, 11: 416-23. 10.1111/j.1524-4733.2007.00287.x.CrossRefPubMed
19.
go back to reference Fisher LJ, Goldney RD, Grande ED, Taylor AW, Hawthorne G: Bipolar disorders in Australia: A population-based study of excess costs. Soc Psychiatry Psychiatr Epidemiol. 2007, 42: 105-9. 10.1007/s00127-006-0133-4.CrossRefPubMed Fisher LJ, Goldney RD, Grande ED, Taylor AW, Hawthorne G: Bipolar disorders in Australia: A population-based study of excess costs. Soc Psychiatry Psychiatr Epidemiol. 2007, 42: 105-9. 10.1007/s00127-006-0133-4.CrossRefPubMed
20.
go back to reference Olie JP, Levy E: Manic episodes: the direct cost of a three-month period following hospitalisation. Eur Psychiatry. 2002, 17: 278-86. 10.1016/S0924-9338(02)00680-6.CrossRefPubMed Olie JP, Levy E: Manic episodes: the direct cost of a three-month period following hospitalisation. Eur Psychiatry. 2002, 17: 278-86. 10.1016/S0924-9338(02)00680-6.CrossRefPubMed
21.
go back to reference de Zelicourt M, Dardennes R, Verdoux H, Gandhi G, Khoshnood B, Chomette E, Papatheodorou ML, Edgell ET, Even C, Fagnani F: Frequency of hospitalisations and inpatient care costs of manic episodes: in patients with bipolar I disorder in France. Pharmacoeconomics. 2003, 21: 1081-90. 10.2165/00019053-200321150-00002.CrossRefPubMed de Zelicourt M, Dardennes R, Verdoux H, Gandhi G, Khoshnood B, Chomette E, Papatheodorou ML, Edgell ET, Even C, Fagnani F: Frequency of hospitalisations and inpatient care costs of manic episodes: in patients with bipolar I disorder in France. Pharmacoeconomics. 2003, 21: 1081-90. 10.2165/00019053-200321150-00002.CrossRefPubMed
22.
go back to reference Hakkaart-van Roijen L, Hoeijenbos MB, Regeer EJ, ten Have M, Nolen WA, Veraart CP, Rutten FF: The societal costs and quality of life of patients suffering from bipolar disorder in the Netherlands. Acta Psychiatr Scand. 2004, 110: 383-92. 10.1111/j.1600-0447.2004.00403.x.CrossRefPubMed Hakkaart-van Roijen L, Hoeijenbos MB, Regeer EJ, ten Have M, Nolen WA, Veraart CP, Rutten FF: The societal costs and quality of life of patients suffering from bipolar disorder in the Netherlands. Acta Psychiatr Scand. 2004, 110: 383-92. 10.1111/j.1600-0447.2004.00403.x.CrossRefPubMed
23.
go back to reference Das Gupta R, Guest JF: Annual cost of bipolar disorder to UK society. Br J Psychiatry. 2002, 180: 227-33. 10.1192/bjp.180.3.227.CrossRefPubMed Das Gupta R, Guest JF: Annual cost of bipolar disorder to UK society. Br J Psychiatry. 2002, 180: 227-33. 10.1192/bjp.180.3.227.CrossRefPubMed
24.
go back to reference Montoya A, Gilaberte I, Costi M, Perez Sanchez Toledo J, Gonzalez Pinto A, Ma Haro J, Comes M, Vieta E: El trastorno bipolar en España: estado funcional y consumo de recursos según la muestra española del estudio observacional paneuropeo EMBLEM. Vertex. 2007, 18: 13-9.PubMed Montoya A, Gilaberte I, Costi M, Perez Sanchez Toledo J, Gonzalez Pinto A, Ma Haro J, Comes M, Vieta E: El trastorno bipolar en España: estado funcional y consumo de recursos según la muestra española del estudio observacional paneuropeo EMBLEM. Vertex. 2007, 18: 13-9.PubMed
25.
go back to reference Andlin-Sobocki P, Jonsson B, Wittchen H-U: Cost of disorders of the brain in Europe European. Journal of Neurology. 2005, 12 (S1): 1-27. Andlin-Sobocki P, Jonsson B, Wittchen H-U: Cost of disorders of the brain in Europe European. Journal of Neurology. 2005, 12 (S1): 1-27.
26.
go back to reference Gisbert R, Brosa M: Base de Datos de Costes Sanitarios 1997-2004 [CD-ROM] Versión 1.6. 2004, Barcelona: Centro de Estudios en Economía de la Salud y Política Social Gisbert R, Brosa M: Base de Datos de Costes Sanitarios 1997-2004 [CD-ROM] Versión 1.6. 2004, Barcelona: Centro de Estudios en Economía de la Salud y Política Social
29.
go back to reference Kleinman L, Lowin A, Flood E, Gandhi G, Edgell E, Revicki D: Costs of bipolar disorder. Pharmacoeconomics. 2003, 21: 601-22. 10.2165/00019053-200321090-00001.CrossRefPubMed Kleinman L, Lowin A, Flood E, Gandhi G, Edgell E, Revicki D: Costs of bipolar disorder. Pharmacoeconomics. 2003, 21: 601-22. 10.2165/00019053-200321090-00001.CrossRefPubMed
30.
go back to reference Stender M, Bryant-Comstock L, Phillips S: Medical resource use among patients treated for bipolar disorder: a retrospective, cross-sectional, descriptive analysis. Clin Ther. 2002, 24: 1668-76. 10.1016/S0149-2918(02)80070-4.CrossRefPubMed Stender M, Bryant-Comstock L, Phillips S: Medical resource use among patients treated for bipolar disorder: a retrospective, cross-sectional, descriptive analysis. Clin Ther. 2002, 24: 1668-76. 10.1016/S0149-2918(02)80070-4.CrossRefPubMed
31.
go back to reference Bryant-Comstock L, Stender M, Devercelli G: Health care utilization and costs among privately insured patients with bipolar I disorder. Bipolar Disord. 2002, 4: 398-405. 10.1034/j.1399-5618.2002.01148.x.CrossRefPubMed Bryant-Comstock L, Stender M, Devercelli G: Health care utilization and costs among privately insured patients with bipolar I disorder. Bipolar Disord. 2002, 4: 398-405. 10.1034/j.1399-5618.2002.01148.x.CrossRefPubMed
32.
go back to reference Evers S, Salvador-Carulla L, Halsteinli V, McDaid D, the MHEEN group: Implementing mental health economic evaluation evidence: Building a bridge between theory and practice. Journal of Mental Health. 2007, 16: 223-241. 10.1080/09638230701279881.CrossRef Evers S, Salvador-Carulla L, Halsteinli V, McDaid D, the MHEEN group: Implementing mental health economic evaluation evidence: Building a bridge between theory and practice. Journal of Mental Health. 2007, 16: 223-241. 10.1080/09638230701279881.CrossRef
33.
go back to reference Chapko MK, Liu CH, Perkins M, Li YF, Fortney JC, Maciejewski ML: Equivalence of two healthcare costing methods: Bottom-up and top-down. Health Econ. 2008, 18: 1188-201. 10.1002/hec.1422.CrossRef Chapko MK, Liu CH, Perkins M, Li YF, Fortney JC, Maciejewski ML: Equivalence of two healthcare costing methods: Bottom-up and top-down. Health Econ. 2008, 18: 1188-201. 10.1002/hec.1422.CrossRef
34.
go back to reference Revicki DA, Hirschfeld RM, Ahearn EP, Weisler RH, Palmer C, Keck PE: Effectiveness and medical costs of divalproex versus lithium in the treatment of bipolar disorder: results of a naturalistic clinical trial. J Affect Disord. 2005, 86 (2-3): 183-93. 10.1016/j.jad.2005.01.002.CrossRefPubMed Revicki DA, Hirschfeld RM, Ahearn EP, Weisler RH, Palmer C, Keck PE: Effectiveness and medical costs of divalproex versus lithium in the treatment of bipolar disorder: results of a naturalistic clinical trial. J Affect Disord. 2005, 86 (2-3): 183-93. 10.1016/j.jad.2005.01.002.CrossRefPubMed
35.
go back to reference Bridget M: Kuehn Mental Health Courts Show Promise. JAMA. 2007, 297: 1641-1643. 10.1001/jama.297.15.1641. Bridget M: Kuehn Mental Health Courts Show Promise. JAMA. 2007, 297: 1641-1643. 10.1001/jama.297.15.1641.
37.
go back to reference Mental Health Economics European Network (MHEEN-II): 2007, Mental Health and Employment Questionnaire: Spain. Project Report Mental Health Economics European Network (MHEEN-II): 2007, Mental Health and Employment Questionnaire: Spain. Project Report
38.
Metadata
Title
Pattern of healthcare resource utilization and direct costs associated with manic episodes in Spain
Authors
Monica Tafalla
Luis Salvador-Carulla
Jerónimo Saiz-Ruiz
Teresa Diez
Luis Cordero
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2010
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-10-31

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