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  1. Home-based versus hospital-based care for serious mental illness : Controlled cost-effectiveness study over four years.

    Article - En anglais

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0318233

    Code Inist : 002B18I09. Création : 27/11/1998.