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Cost-effectiveness analysis of psychiatric deinstitutionalization.
D Reinharz1, A D Lesage, A P Contandriopoulos
1Centre de recherche, Centre Hospitalier Universitaire de Québec.
Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|September 15, 2000
Summary
Deinstitutionalization of psychiatric patients is a cost-effective strategy that improves mental state and well-being. This approach offers a less expensive alternative to long-term hospitalization for many individuals.
Area of Science:
- Psychiatry
- Health Economics
- Social Work
Background:
- The cost-effectiveness of deinstitutionalization for patients with severe and persistent mental disorders is debated.
- Long-term hospitalization remains a common care model.
Purpose of the Study:
- To evaluate the cost-effectiveness and patient outcomes of deinstitutionalization compared to continued hospitalization.
- To assess the impact of deinstitutionalization on clinical and social dimensions, and quality of life.
Main Methods:
- Retrospective cohort study of 96 pairs of psychiatric patients.
- One patient in each pair was deinstitutionalized between 1989 and 1998.
- Follow-up for nearly 10 years, documenting all medical and social services, and evaluating clinical, social, and quality of life dimensions.
Main Results:
- Deinstitutionalized patients showed more positive outcomes on several dimensions compared to hospitalized patients.
- Lower daily living costs for deinstitutionalized patients offset community-based treatment service costs.
- The study indicates a favorable economic balance for community care.
Conclusions:
- Deinstitutionalization, as implemented, is a less costly option than continued hospitalization for many patients.
- This approach is likely to improve patients' mental state and overall well-being.
- The findings support community-based care as a viable and beneficial alternative.