The mental health care in the Sanitary District of Amandola (FM)
T. Damiani1, M. Passamonti 2, T. On Angelo2, N. Kardos2, N. Raffaelli3, F. 3 Rossi, V. Barchetti3, M.G. 3 Ciarrocchi, P. 3 Deales, G. Fiori3, G. 3 Gallo, M. Gaspari3, L. Liberati3, B. Maddalena3, A. Pucci3, A. Sacconi3, L. 3 Siliquini, D. Vallesi3, G. Giannini4, S. Pacifici4,M.Mariani1.
1ASUR Marche - Z.T. AP 13, Department of Mental Health; 2ASUR Marche - ZT AP 13, District of Amandola, 3Medici of General Medicine, ASUR Marche - ZT AP 13, District of Amandola, 4 Psychologists, Project Relief, Marche Region XXIV Territorial Area.
We have calculated the costs ofhealth carein a cohortof n. 85 patientsagedbetween 18 and55 years, for the period1998 to 2008followed byDept of mental health because of serious illness, ICD 295-296-297and 301. The area of research is the Sanitary District of Amandola (11 municipalities of the Sibillini Mountain Community, south of the Marche Region).
Our decision to limit the study to patients under 55 years of age was determined by the choice of observing these patients in their working-age, limiting pollution data because of cognitiveimpairment induced by ageeing.
It was calculated for each patient the annual number of admissions to acute psychiatric ward in the Hospitalof Ascoli Piceno and in the psychiatric clinic of Ascoli Piceno (subacute hospitalization). It was also calculated the annual cost per patient for community care and home visits for the outpatients.
There have been 39 patients who underwent admissions to SPDC (22 patients had only one admission and 16 more than one admission), while 46 patients had no hospitalization at all in the period observed(1998-2008).
The total cost for hospital care is € 114,320.00 and the minimum and maximum costs for hospital costs respectively € 2,465.00 and € 8.000,00. The total cost for the service area is € 47,245.00, the minimumand maximum cost for community care (home visits for the outpatients and drugs) are respectively € 17.16 (for 1 outpatient visit /year) and € 588.94 (18 home visits/year + long acting drugs). Costs are defined in accordance with regional rates at DGRM 2265/02.
The data in our record indicate a low costs of the hospital psychiatric care, much less than for other studies, andas well as there is the containment of retirement to illness 7 patients in ten years of 85.
The joint work between the community health workers, hospital of Amandola, general practitioners, social workers and mental health dept. , has achieved these results in terms of health and social spending.
Next this survey has now reached the second year the survey of subjective health status among the same patients, with the administration of the SF36 questionnaire and to the own family members from this year it was proposed the questionnaire QOL-Proxy.
A further current study is the longitudinal assessment of cognitive deficits in patients followed for serious disease. In this case the patient is proposed to carry the battery of neuropsychological tests each year.