OBJECTIVE: The effects of risperidone treatment on health care
utilization and treatment costs were examined among patients with
treatment-refractory schizophrenia or schizoaffective disorder. METHODS:
Data from the Santa Clara County Mental Health Department were used to
measure inpatient and ambulatory services and outpatient medications
related to the treatment of mental disorders. Data for 139 patients were
analyzed for periods before and after initiation of risperidone treatment.
A mean +/- SD of 14 +/- 2.1 months of data were available in both the
before and after periods, for a mean total study period of 28 months.
RESULTS: The patients' mean age was 40 years (range, 18 to 78 years), and
46 percent were women. After the start of risperidone treatment, days in
acute care inpatient facilities were reduced by 26 percent, and days in
residential treatment were reduced by 57 percent. These reductions were
accompanied by an increase in the use of lower-cost services, such as
community living, treatment planning, and partial hospital-day treatment.
There was a 3.4 percent increase in total psychiatric health care costs
after initiation of treatment with risperidone. CONCLUSIONS: Overall,
risperidone treatment resulted in a shift or resource utilization from
provider-delivered services to pharmaceutical care without a significant
change in total health care cost.