A Comparative Study On Economic Burden Of Schizophrene And Psychological Burden Of Her Caregiver

Objects: 1.To investigate medical nurse cost,psychological burden of the caregivers of the schizophrene and find correltional cause in schizophrene at different hospital. 2. To reduce medical nurse cost and raise benefits in schizophrene, and To alleviate the psychological burden of the caregiver of the schizophrene.Methods: A comparative study was carried out among schizophrene at the Psychiatry Department of polyclinic (67), the madhouse of Yunnan province(96) and the mental health center of Yunnan province(76), 238 patients with schizophrene were picked. Diagnosis criteria of schizophrene was used by Diagnostic and statistical manual of mental disorders 4th ed (DSM-Ⅳ) ;The direct cost and indirect cost of lost worker time of caregivers was obtained from direct data of caregivers,hospital, used by self-design economic burden investigation scale and the indirect of cost of the schizophrene patients from computation of human capital method, in the end, Cost-effectiveness analysis was computed .The schizophrene were assessed with SQLS, ADL and self-design common data and economic burden investigation scale etc. The psychological burden of the caregivers of the schizophrene were assessed with RSS,FBS,SS,WHOQOL-BREF, etc. One-way analysis of variance, (One-way ANOVA) and Multivariate regression analysis were used to analysis them correlative factor.Reasults:1.There was a significant difference among the three groups on the general character except marriage,nationality and the degree of culture. It was 80% patients at the Psychiatry Department of polyclinic that was not in hospitalization insurance: There were 73.91% patients in closed ward who was in hospitalization insurance,moreover, 61% patients in open ward who was not in hospitalization insurance;The course of diseases was singnificant longer in the closed ward (M=174 months) than that of the open ward (M=36 months)。2.The most of the caregivers were the father,mother or spouse of the schizophrene;It is special that some caregivers were colleagues at the mental health center of Yunnan province. The most of the caregivers were the father,mother or spouse of the schizophrene in open ward,however in closed ward mostly children,brothers and sisters or colleagues visited the schizophrene.3.The most factor that inflenced the stress of the caregivers was the family burden,the more heavy family burden, the higher stress of the caregivers;the severity of the schizophrenia quality of life and the activity of daily life could enhance the stess of the caregivers.4,The direct cost of patient was different among three hospitals,between open ward and closed ward.5.According the improvement of the quality of life,the C/E(cost/effectiveness) of the madhouse of Yunnan province was lowest among three hospitals; According the improvement of the activity of daily life,the C/E(cost/effectiveness) of the mental health center of Yunnan province was lowest among three hospitals; the C/E(cost/effectiveness) of the open ward was lower between two kinds of ward.Conclusions:1. Due to impersonal factor, there were a significant difference among the three groups on the general character of the patient and her family, however the schizophrene is so serious that the annal income of family was not statistically different among the three groups,between open ward and closed ward.2.Looking after the schizophrene was a ridden job,it was difficult to find a people who was with pleasure to do it. Multivariate regression analysis showed that the most factor that inflenced the stress of the caregivers was the family burden,the more heavy family burden,the higher stress of the caregivers;the severity of the chizophrenia quality of life and the activity of daily life could enhance the stess of the caregivers,When course of disease was longer, caregivers thinked that it was impossibale to get well through treatment,so the stress of the caregivers lightened.3. The C/E(cost/effectiveness) of three hospitals showed that it was unpractical to improve the quality of life and the activity of daily life by drugs in little; The C/E(cost/effectiveness) of open ward and closed ward showed that a long treatment in open ward was a better choice for patient,famliy and whole society.