Comparing patterns and costs of schizophrenia care in five European countries: the EPSILON study

Objective: To compare service utilization and cost profiles of people with schizophrenia living in Europe in order to understand differences in treatment and care costs. Method: Cross-sectional samples were taken of people with schizophrenia in five European locations. Sociodemographic, clinical and service use data were collected via interviewer-administered questionnaires. Site-specific unit costs were obtained, transformed subsequently into a single currency (UK pound). Multiple regression analyses were conducted. Results: There were widespread and considerable differences between sites in service utilization patterns and associated costs. Higher needs greater symptom severity and longer psychiatric history are associated with higher costs: quality of life and service satisfaction are not. Few differences were found between sites in patterns of association with cost. Conclusion: Comparative analyses of the use and cost of mental health services can highlight existing variations helpfully in service provision and uptake. Methodological consistency is required if meaningful conclusions are to be drawn from such comparative data.