From administrative data to improved schizophrenia care

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Promotion S. Konings

In this thesis of Steef Konings we investigate how care is used by people with schizophrenia and other psychotic disorders (SSD), and how their health develops over time. A health economic model is developed to more realistically predict the healthcare costs and outcomes for these patients. In addition, the cost-effectiveness of Cognitive Behavioral Therapy for Psychosis (CBTp), a treatment with insufficiently known costs and benefits, is analyzed.

The research is based on data from nearly 17,000 patients from the northern Netherlands, collected between 2000 and 2019. The results show that while the number of patients in specialized care decreased, the intensity of care per patient increased. Additionally, it is found that SSD patients lose an average of 9.5 years of life, with men generally losing more years than women. This highlights the importance of targeted interventions to improve life expectancy and quality of life.

Furthermore, the analyses demonstrate that CBTp is cost-effective in more than half of the cases. Expanding the availability of effective and cost-effective treatments like CBTp can not only lead to health benefits for patients but also lower long-term healthcare costs. Policymakers and healthcare providers should work to increase access to CBTp and ensure that financial or capacity barriers no longer limit the availability of this treatment. Doing so would not only improve patients' quality of life but could also alleviate pressure on the mental healthcare system.