Cost-benefit of a depot neuroleptic clinic: 10 years' follow-up of functioning of a clinical-administrative model

The purpose of the study was to compare die costs of the hospitalizations of 205 psychotic patients before entering an outpatient Depot Neuroleptic Clinic (PreDNC) with the costs of the admissions of this group of patients, occurring over a 10-year follow-up period of functioning of the unit after entering the Depot Clinic (InDNC). The cost-benefit ratio and the operating costs of this outpatient unit were assessed. The average years of illness of the sample studied PreDNC and InDNC were 8.6±6.5 years and 7.1±3.1 years respectively (NS), which included a total of 671 hospitalizations (511 PreDNC and 160 InDNC). Hospitalizations PreDNC accounted for 47,600 inpatient days in contrast to 11,100 inpatient days InDNC, representing a reduction of 77% in the total costs of hospitalization: year/inpatient PreDNC US$223 versus US$51 InDNC. The ambulatory care cost in the InDNC period for the sample studied included 38,700 consultations, provided by a multidisciplinary team, and pharmacological expenses. The number of interventions given by the nurse assistants was fivefold (25,900) those given by the doctor (5,600) and threefold (7,900) those given by the nurse. However, the cost of nurse assistant intervention is 20% of that required for a physician and 25% of that for nurses. The DNC represented a clinical-administrative model with low operating costs and high cost-benefit ratio, being a suitable model in mental care policies addressing the long-term management of chronic psychotic patients. □ Cost-benefit, Deponeuroleptics, Organization, Schizophrenia.