Severe and persistent mental illnesses are often lifelong and characterized by intermittent exacerbations requiring hospitalization.
Providing needed care within budgetary constraints to this largely publicly subsidized population requires technologies that reduce costly inpatient episodes.
The authors report a prospective randomized trial to test the clinical effectiveness of a model of acute residential alternative treatment for patients with persistent mental illness requiring hospital-level care.
Patients enrolled in the Montgomery County, Md., public mental health system who experienced an illness exacerbation and were willing to accept voluntary treatment were randomly assigned to the acute psychiatric ward ofa general hospital or a community residential alternative.
There were no psychopathology-based exclusion criteria.
Treatment episode symptom improvement, satisfaction, discharge status, and 6-month pre-and postepisode acute care utilization, psychosocial functioning, and patient satisfaction were assessed.
Of 185 patients, 119 (64%) were successfully placed at their assigned treatment site.
Case mix data indicated that patients treated in the hospital (N=50) and the alternative (N=69) were comparably ill.
Treatment episode symptom reduction and patient satisfaction were comparable for the two settings. (...)
Mots-clés Pascal : Trouble psychiatrique, Grave, Traitement, Hospitalisation, Hôpital général, Service hospitalier, Psychiatrie, Etude comparative, Institution, Efficacité traitement, Analyse coût, Economie santé, Système santé, Maryland, Etats Unis, Amérique du Nord, Amérique, Santé mentale, Homme, Placement institution, Alternative hospitalisation
Mots-clés Pascal anglais : Mental disorder, Severe, Treatment, Hospitalization, General hospital, Hospital ward, Psychiatry, Comparative study, Institution, Treatment efficiency, Cost analysis, Health economy, Health system, Maryland, United States, North America, America, Mental health, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0286289
Code Inist : 002B18I09. Création : 27/11/1998.