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Rev Saude Publica. 2011 Feb;45(1):14-23. Epub 2010 Nov 12.

Direct medical costs associated with schizophrenia relapses in health care services in the city of São Paulo.

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  • 1Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.

Erratum in

  • Rev Saude Publica. 2011 Apr;45(2):440.



To assess direct medical costs associated with schizophrenia relapses in mental health services.


The study was conducted in three health facilities in the city of São Paulo: a public state hospital; a Brazilian National Health System (SUS)-contracted hospital; and a community mental health center. Medical records of 90 patients with schizophrenia who received care in 2006 were reviewed. Information on inpatient expenditures was collected and used for cost estimates.


Mean direct medical cost of schizophrenia relapses per patient was US$ 4,083.50 (R$ 8,167.58) in the public state hospital; US$ 2,302.76 (R$ 4,605.46) in the community mental health center; and US$ 1,198.50 (R$ 2,397.74) in the SUS-affiliated hospital. The main component was daily inpatient room rates (87% - 98%). Medication costs varied depending on the use of typical or atypical antipsychotic drugs. Atypical antipsychotic drugs were more often used in the community mental health center.


Costs associated with schizophrenia relapses support investments in antipsychotic drugs and strategies to reduce disease relapse and the need for mental health inpatient services. Treating patients in a community mental health center was associated with medium costs and added the benefit of not depriving these patients from family life.

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