Alternatives to standard acute in-patient care in England: short-term clinical outcomes and cost-effectiveness

Authors:
Publisher website
Google Scholar
Abstract
Background: Outcomes following admission to residential alternatives to standard in-patient mental health services are underresearched.Aims: To explore short-term outcomes and costs of admission to alternative and standard services.Method: Health of the Nation Outcome Scales (HoNOS), Threshold Assessment Grid (TAG), Global Assessment of Functioning (GAF) and admission cost data were collected for six alternative services and six standard services.Results: All outcomes improved during admission for both types of service (n = 433). Adjusted improvement was greater for standard services in scores on HoNOS (difference 1.99, 95% CI 1.12–2.86), TAG (difference 1.40, 95% CI 0.39–2.51) and GAF functioning (difference 4.15, 95% CI 1.08–7.22) but not GAF symptoms. Admissions to alternatives were 20.6 days shorter, and hence cheaper (UK£3832v. £9850). Standard services cost an additional £2939 per unit HoNOS improvement.Conclusions: The absence of clear-cut advantage for either type of service highlights the importance of the subjective experience and longer-term costs.

This publication has 23 references indexed in Scilit: