Background The Daily Living Programme (DLP) offered intensive home-based care with problem-centred case management for seriously mentally ill people facing crisis admission to the Maudsley Hospital, London.
The cost-effectiveness ofthe DLP was examined over four years.
Method A randomised controlled study examined cost-effectiveness of DLP versus standard in/out-patient hospital care over 20 months, followed by a randomised controlled withdrawal of halfthe DLP patients into standard care.
Three patient groups were compared over 45 months : DLP throughoutthe period.
DLP for 20 months followed by standard care, and standard care throughout.
Bivariate and multivariate analyses were conducted (the latter to standardise for possible inter-sample differences stemming from sample attrition and to explore sources of within-sample variation).
Results The DLP was more cost-effective than control care over months 1-20, and also over the full 45-month period, butthe difference between groups may have disappeared by the end of month 45.
Conclusions The reduction of the cost-effectiveness advantage for home-based care was perhaps partly due to the attenuation of DLP care, although sample attrition left some comparisons under-powered.
Mots-clés Pascal : Trouble psychiatrique, Aigu, Traitement, A domicile, Ambulatoire, Etude comparative, Hospitalisation, Analyse coût, Economie santé, Traitement communautaire, Angleterre, Grande Bretagne, Royaume Uni, Europe, Santé mentale, Homme
Mots-clés Pascal anglais : Mental disorder, Acute, Treatment, At home, Ambulatory, Comparative study, Hospitalization, Cost analysis, Health economy, Community treatment, England, Great Britain, United Kingdom, Europe, Mental health, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0318233
Code Inist : 002B18I09. Création : 27/11/1998.