In-patient care costs of patients with bipolar I disorder: A comparison between two European centers

Gonzalez-Pinto, A.M.; Dardennes, R.; de Zélicourt, M.; López, P.; Oliveros, R.G.; Vieta, E.; Barbeito, S.; Echevarria, E.; Fagnani, F.

doi:10.1016/j.jad.2009.05.010

« Previous Next »Journal of Affective Disorders
Volume 121, Issue 1 , Pages 152-155, February 2010

In-patient care costs of patients with bipolar I disorder: A comparison between two European centers

A.M. Gonzalez-Pinto
- CIBERSAM, Santiago Apóstol Hospital, Vitoria, University of the Basque Country, Spain
- Corresponding author. Division of Psychiatry Research, Santiago Apostol Hospital, Olaguibel 29, 01004 Vitoria-Gasteiz, Alava, Spain. Tel.: +34 945007770; fax: +34 945 007764.
R. Dardennes
- Clinique des Maladies Mentales et de l'Encéphale, Sainte-Anne Hospital, Paris, Cochin Faculty of Medicine, University Paris 5, Paris, France
M. de Zélicourt
- University of Bask Country, Spain
P. López
- CIBERSAM, Santiago Apóstol Hospital, Vitoria, University of the Basque Country, Spain
R.G. Oliveros
- CIBERSAM, Santiago Apóstol Hospital, Vitoria, University of the Basque Country, Spain
E. Vieta
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
S. Barbeito
- CIBERSAM, Santiago Apóstol Hospital, Vitoria, University of the Basque Country, Spain
E. Echevarria
- University of Bask Country, Spain
F. Fagnani
- Cemka-Eval, Bourg-la-Reine, France

Received 28 January 2009; received in revised form 13 May 2009; accepted 13 May 2009.

Abstract

Background

Bipolar disorder (BPD) is a disabling disease with high morbidity rates. An international (Spain, France) comparative study about hospitalizations and in-patient care costs associated with BPD I was performed. Centers were included if they had access to a database of computerized patient charts exhaustively covering a defined catchment area.

Methods

Economic evaluation was performed by multiplying the average cumulated annual length of stay (LOS) of hospitalized bipolar patients by a full cost per day of hospitalization in each center to obtain the corresponding annual costs.

Results

Hospitalization rates per annum and per 100,000 individuals (general population aged 15+) were similar between France (43.6) and Spain (43.1). There were only slight differences in relation to length of stay (LOS) per patient hospitalized with 18.1 days in Spain and 20.4 days in France. The overall estimated annual hospitalization costs were in the same order of magnitude after adjustment to an adult population of 100,000: €232,000 (Spain) and €226,500 (France). Mixed episodes had the longest LOS followed by depressive episodes, while manic episodes had the shortest ones. Mania was the most costly disorder representing 53.7% of annual BPD in-patient care costs.

Conclusions

BPD I care requires large resources and frequent hospitalizations, especially during manic episodes. Depressive and mixed episodes require longer hospital stays than manic episodes. Out-patient costs should now be evaluated.

Keywords: Bipolar disorders, Cost of illness, Hospitalization, Mania, Depression, France, Spain, CIBERSAM