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Direct and indirect cost of schizophrenia in outpatients treated in a tertiary care psychiatry unit.

OBJECTIVE
To estimate the direct and indirect cost of care incurred by patients with schizophrenia attending a tertiary care psychiatry unit in Colombo.


METHODS
Study was carried out at the National Hospital of Sri Lanka. Systematic sampling selected every second patient with an ICD-10 clinical diagnosis of schizophrenia presenting to the clinic during a two month period. Investigator administered semi-structured questionnaire was used for data collection.


RESULTS
Sample consisted of 91 patients. Direct cost was defined as cost incurred by the patient (out of pocket expenditure) for outpatient care. Mean cost of a clinic visit was Rs. 500. Of the clinic visit cost, highest proportions were travel cost (39.8%) and medication (26.4%). Sixty four (70.3%) had received informal care. The mean cost of informal care during the entire course of the illness was Rs. 33, 540. Mean indirect cost was Rs. 150,190.


CONCLUSIONS
Despite low direct cost of care, indirect cost and cost of informal treatment results in substantial economic impact on patients and their families. It is recommended that economic support should be provided for patients with disabling illnesses such as schizophrenia, especially when patients are unable to engage in full time employment. There is a need to educate the public regarding higher cost of care by traditional healers and other informal modes of treatment compared to Western medical care.