Costs of psychiatric residential care in Italy [I costi delle strutture residenziali psichiatriche italiane]

Objective: The aims of this study are: (1) to estimate patients' costs in Italian non hospital Residential Facilities (RF); (2) to analyse the relationship between the costs of care received by residents and patients' or facilities characteristics. Method: The PROGRES study included all Italian private and public RF (1370) with more than 4 beds. Of those, 265 were selected through stratified random sampling to be included in phase 2. Data were obtained through a schedule filled in by the facility manager. Additional information about costs related to the use of Community Psychiatric Service (CPS) by residents has also been collected. The cost components of residential accommodation include the costs of the RF, of the CPS, of general medical care, of the informal assistance provided by family or friends, and other non-medical costs. Results: The mean annual cost of stay in RFs was approximately 34,000 Euro, and it was related to the RF size and to staffing levels. Both RF and CPS are more expensive in the north of Italy, as compared to the center and the south. Costs were lower for older patients. CPS costs are lower when RF staffing levels are higher. Conclusions: In general, patients in RFs cost between 20,000 and 40,000 Euro per year; to this sum, additional 2,000-6,000 Euros per year should be added to include the costs of care provided outside the facility. Both RFs and CPS have different costs depending on the geographical area where the facilities are located, and staffing levels. Changes in CPS costs seem to be related to patients' characteristics.