The objective of this study was to compare the outcomes and costs of intensive case management with routine case management for a group of severely disabled patients with a mental illness.
A cost-effectiveness analysis was conducted alongside a randomised controlled trial.
Seventy-three patients, who reside in the eastern suburbs of Sydney, were randomly allocated to either intensive or routine case management.
Staff providing intensive case management had substantially lower caseloads than staff providing routine case management.
The main health outcome measured was patients'level of functioning as measured by the Life Skills Profile.
Costing data were collected from hospital services, mental health services, general health services, community services and informal carers.
At 12 months, outcome and costing data were analysed on 58 patients and hospitalisation data were analysed on 68 patients.
Significantly more patients in the intensive case management group remained in treatment (x2=6.00, df=1, p<0.01) and showed a clinically significant improvement in functioning from baseline to 12 months (x2=4.50, df=1, p<0.05).
The mean cost per patient was $7745 more in the intensive group than in the routine group (t=1.49, df=56, p>0.01) over 12 months.
The cost-effectiveness ratio indicated a cost of $27 661 per year for one additional patient in the intensive case management group to make a clinically significant improvement in functioning. (...)
Mots-clés Pascal : Service santé, Santé mentale, Coût financement, Efficacité traitement, Trouble psychiatrique, Evolution, Australie, Océanie, Homme
Mots-clés Pascal anglais : Health service, Mental health, Financing cost, Treatment efficiency, Mental disorder, Evolution, Australia, Oceania, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0404940
Code Inist : 002B18H05B. Création : 25/01/1999.