TY - JOUR
T1 - Cost of borderline personality disorder in Catalonia (Spain)
AU - Salvador-Carulla, L.
AU - Bendeck, M.
AU - Ferrer, M.
AU - Andión, null
AU - Aragonès, E.
AU - Casas, M.
N1 - Funding Information:
We would like to thank all the members of the BPD Cost Group: Constança Alberti (Catalan Institute of Medical Evaluations), Carmen Barral (Psychiatry Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain), Natalia Calvo (Psychiatry Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain), Andrea Di Genova (Psychiatry Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain), Beatriz Gancedo (Psychiatry Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain), Karina Gibert (Department of Statistics and Operations Research, Universitat Politècnica de Catalunya, Barcelona, Spain), Begoña Gonzalvo (CAS Vall d’Hebron, Psychiatry Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain), Lluís Lalucat (Centre d’Higiene Mental Les Corts, Barcelona, Spain), Mònica Lavilla (ACAI-TLP, Barcelona, Spain), Cristina Molina (Pla Director de Salut Mental i Addiccions, Departament de Salut, Government of Catalonia), José Eduardo Montejo (Psychiatry Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain), Álvaro Muro (Unitat d’Hospitalització Psiquiàtrica Penitenciària de Catalunya, Parc Sanitari Sant Joan de Déu, Barcelona, Spain), Juan Carlos Pascual (Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain), Mònica Prat (Psychiatry Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain). Financial support: this study was financially supported with public funds from the Pla Director de Salut Mental i Addiccions (Master Plan for Mental Health and Addictions, Department of Health) of the Government of Catalonia and grants from the Obra Social–Fundació “la Caixa”.
Publisher Copyright:
© 2014 Elsevier Masson SAS.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Introduction: The available information on the cost of illness of Borderline Personality Disorder (BPD) is overtly insufficient for policy planning. Our aim was to estimate the costs of illness for BPD in Catalonia (Spain) for 2006. Methods: This is a multilevel cross-design synthesis study combining a qualitative nominal approach, quantitative 'top-down' analysis of multiple health databases, and 'bottom-up' data of local surveys. Both direct and indirect costs have been estimated from a governmental and societal perspective. Results: Estimated year-prevalence of BPD was 0.7% (41,921cases), but only 9.6% of these cases were treated in the mental health system (4033cases). The baseline of the total cost of BPD in Catalonia was 45.6million. €, of which 15.8million. € (34.7%) were direct costs related to mental health care. The cost distribution was 0.4% in primary care; 4% in outpatient mental health care; 4.7% in hospitalisation; 0.7% in emergency care; and 24.9% in pharmacotherapy. Additionally, the cost of drug addiction treatment for persons with BPD was 11.2%; costs associated with sheltered employment were 23.9% and those of crime and justice were 9.7%. Indirect costs -including temporary sick leave and premature death (suicide)- represented 20.5% of total costs. The average annual cost per patient was 11,308. €. Conclusions: An under-reporting of BPD was identified by the experts in all health databases and official registries. Most of the BPD costs were not related to mental health care. Amongst the direct cost categories, pharmacotherapy had the largest proportion despite the lack of specificity for BPD. This distribution of costs reinforces the idea of BPD complexity related to an inadequate and inefficient use of health resources.
AB - Introduction: The available information on the cost of illness of Borderline Personality Disorder (BPD) is overtly insufficient for policy planning. Our aim was to estimate the costs of illness for BPD in Catalonia (Spain) for 2006. Methods: This is a multilevel cross-design synthesis study combining a qualitative nominal approach, quantitative 'top-down' analysis of multiple health databases, and 'bottom-up' data of local surveys. Both direct and indirect costs have been estimated from a governmental and societal perspective. Results: Estimated year-prevalence of BPD was 0.7% (41,921cases), but only 9.6% of these cases were treated in the mental health system (4033cases). The baseline of the total cost of BPD in Catalonia was 45.6million. €, of which 15.8million. € (34.7%) were direct costs related to mental health care. The cost distribution was 0.4% in primary care; 4% in outpatient mental health care; 4.7% in hospitalisation; 0.7% in emergency care; and 24.9% in pharmacotherapy. Additionally, the cost of drug addiction treatment for persons with BPD was 11.2%; costs associated with sheltered employment were 23.9% and those of crime and justice were 9.7%. Indirect costs -including temporary sick leave and premature death (suicide)- represented 20.5% of total costs. The average annual cost per patient was 11,308. €. Conclusions: An under-reporting of BPD was identified by the experts in all health databases and official registries. Most of the BPD costs were not related to mental health care. Amongst the direct cost categories, pharmacotherapy had the largest proportion despite the lack of specificity for BPD. This distribution of costs reinforces the idea of BPD complexity related to an inadequate and inefficient use of health resources.
KW - Borderline personality disorder
KW - Cost of illness
KW - Health economics
KW - Qualitative research
KW - Quantitative analysis
UR - http://www.scopus.com/inward/record.url?scp=84908129631&partnerID=8YFLogxK
U2 - 10.1016/j.eurpsy.2014.07.001
DO - 10.1016/j.eurpsy.2014.07.001
M3 - Article
C2 - 25174269
AN - SCOPUS:84908129631
SN - 0924-9338
VL - 29
SP - 490
EP - 497
JO - European Psychiatry
JF - European Psychiatry
IS - 8
ER -