As part of the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), 200 patients diagnosed with schizophrenia, schizoaffective disorder or delusional disorder, are studied. The aim is to provide up-to-date costs for a defined patient population with schizopsychotic disorders in Sweden.

We identify the actual clinical management of illness and explain cost variability. Costs are combined with information on outcomes and severity of the disorder.

Total costs per patient-year amount to 62.320 Euro. Direct costs correspond to 41% and indirect costs to 59% of total costs. Inpatient and outpatient care corresponds to 7% each of total costs, while costs for special housing and assistance at home is estimated to 22% of total costs. Medication only corresponds to 3% of total costs.

We conclude that costs differ between patients depending on illness severity. Also a reallocation has taken place during the last 15 years between different cost items, from direct costs to indirect costs and from in-patient care at hospitals to out-patient care and assistance at home. The main cost driver is indirect costs due to decreased working ability and premature death. Special housing and home-assistance is the second largest cost item. In-patient care corresponds to 7% of total costs, which 15 years ago amounted to 50% of total costs. This reflects the change in care of schizopsychotic patients. Instead of treating patients at institutions, patients are now to a large extent living in their own housing but often receiving some kind of assistance at home provided by the local municipality.