This study aimed to compare the costs of treatment by community-based and hospital-based psychiatric services.
The design entailed random allocation of patients presenting with psychiatric emergencies over a subsequent 3-month period to one of two services, followed by retrospective quantification of service use and its cost for each group.
One hundred patients with emergency presentations to the psychiatric service via the Accident and Emergency Department, liaison psychiatrist and approved social worker were included in the study.
Their use of a range of items of service was recorded and disaggregated costings of these items of service was calculated.
The use of non-psychiatric services was similar for both groups, but the use of psychiatric services differed, with the hospital group making greater use of in-patient beds and the community group employing more frequent home-based interventions.
The total cost of treatment for the community group (£56 000) was much lower than for the hospital group (£130 000), although the median patient cost was 50% higher in the community group (£938 v. £610), and a greater proportion of the community service expenditure (10% v. 2%) was due to failed contacts.
Taken together with clinical outcome, which showed no advantages for the hospital-based service over the community-based service, our findings suggest that this form of community psychiatric service is a cost-efficient alternative to hospital-based care for this group of patients.
Mots-clés Pascal : Urgence psychiatrique, Trouble psychiatrique, Etude comparative, Traitement communautaire, Psychiatrie communautaire, Hospitalisation, Analyse coût, Economie santé, Royaume Uni, Europe, Utilisation, Service santé, Adulte, Homme, Vieillard
Mots-clés Pascal anglais : Psychiatric emergency, Mental disorder, Comparative study, Community treatment, Community psychiatry, Hospitalization, Cost analysis, Health economy, United Kingdom, Europe, Use, Health service, Adult, Human, Elderly
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0351589
Code Inist : 002B18H05B. Création : 10/04/1997.