This proposal is a plan of research work over 3 years to (i) establish standardised European measures of service outcomes and costs for people with schizophrenia, (ii) use these measures in a multi-site study to evaluate services, (iii) disseminate these measures and the results of the study. The study sites are Amsterdam, Copenhagen, London, Santander and Verona.
The work consists of 2 stages. In stage 1, the common standardised measures will be prepared for the study. In stage 2 these measures will be used in the five centres to study the outcomes and cost-effectiveness of services for representative samples of patients with schizophrenia (n=500).
The study has 6 components :
i To develop instrumentation. Specifically, we shall facilitate the development of short, reliable and valid measures of : needs assessment for the mental ill; family burden for relatives of the mentally ill; satisfaction with services by patients, relatives and staff; mental health service costs and mental health services utilisation.
ii To obtain and compare data from 5 European sites about the quality and outcomes of care (in terms of symptom reduction, disability prevention, needs for care, care-giver burden, and patient satisfaction) under different systems of financing health care. Countries will be selected to represent a range of health care payment styles, and the results will reflect upon similar payments systems elsewhere, in the EU.
iii To calculate and compare the total and component costs of care, including direct costs falling to health service agencies, and also the indirect costs borne by other agencies (social services housing, criminal justice), by families of people with schizophrenia, by sufferers themselves, and by the wider society; and so to compare the total economic consequences of different mental health care systems.
iv To examine the associations between need/costs and outcomes for people with schizophrenia, comparing these relationships between 5 countries.
v To describe and compare the "mixed economy of mental health care" - the service components of care/treatment, and the means by which these services are funded or purchased/commissioned -across 5 European countries, by concentrating on people with schizophrenia.
vi To collect and coordinate information on the pharmaco-epidemiology of treatment for patients suffering from schizophrenia in 5 European countries. This project will agree standard descriptions of treatment regimes and dose equivalents, and compare the types of pharmacological treatments, doses, routes of administration, staffing management, and economic costs, between 5 European sites.