This study examined the mental health service utilization and costs of 321 discharged state hospital patients during a 3-year follow-up period compared with costs if the patients had remained in the hospital.
The study subjects were long-stay patients discharged from Philadelphia State Hospital after 1988.
A longitudinal integrated database on all mental health and medical services reimbursed by Medicaid and Medicare as well as state-and county-funded services was used to construct service utilization and unit cost measures.
During the 3-year period after discharge, 20% - 30% of the patients required rehospitalization an average of 76-91 days per year.
The percentage of rehospitalized patients decreased over time, but the number of hospital days increased.
All of the discharged patients received case management services, and a majority also received outpatient mental health care (66% - 70%) and residential services (75%) throughout the follow-up period.
The total treatment cost per person was approximately $60,000 a year after controlling for inflation, with costs rising slightly over the 3-year period.
The estimated cost of state hospitalization, with the use of 1992 estimates, would have been $130,000 per year if the patients had remained institutionalized. (...)
Mots-clés Pascal : Service santé, Utilisation, Sortie hôpital, Santé mentale, Traitement communautaire, Analyse coût, Etude longitudinale, Etats Unis, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Health service, Use, Hospital discharge, Mental health, Community treatment, Cost analysis, Follow up study, United States, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0349196
Code Inist : 002B18I11. Création : 14/12/1999.