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[Community-integrated acute psychiatric care. Options and limitations]
H D Brenner1, U Junghan, M Pfammatter
1Universitäre Psychiatrische Dienste (UPD) Bern.
Der Nervenarzt
|October 24, 2000
Summary
Community-integrated psychiatric care, including home-based and day hospital treatment, is as effective as inpatient care for acute illness. These approaches reduce hospitalizations, improving cost-effectiveness and addressing the "revolving door phenomenon".
Area of Science:
- Psychiatry
- Mental Health Services Research
- Healthcare Policy
Background:
- The deinstitutionalization of psychiatric care has led to reduced hospital beds and shorter inpatient stays, yet increased admissions, often termed the "revolving door phenomenon."
- Community mental health services primarily focus on rehabilitation, necessitating better integration of acute care within the community.
- Effective psychiatric care reform requires addressing the "revolving door phenomenon" through community-integrated treatment for acutely ill patients.
Purpose of the Study:
- To evaluate the efficacy of community-integrated treatment modalities for acute psychiatric illness.
- To assess the impact of home-based and day hospital treatment on hospitalization rates.
- To determine the cost-effectiveness of community-integrated psychiatric care compared to traditional inpatient care.
Main Methods:
- Review of studies established since the mid-1960s on community-integrated treatment for acute psychiatric illness.
- Comparison of outcomes between home-based treatment, day hospital treatment, and inpatient care.
- Analysis of hospitalization rates and cost-effectiveness data for different treatment modalities.
Main Results:
- Community-integrated approaches, specifically home-based and day hospital treatment, have demonstrated efficacy for acute psychiatric illness.
- These modalities appear as effective as inpatient care for specific patient groups.
- Home-based and day hospital treatment significantly reduce the need for hospitalization, contributing to cost-effective psychiatric care.
Conclusions:
- Community-integrated treatment models are effective alternatives to inpatient care for acute psychiatric conditions.
- Implementing these approaches can help mitigate the "revolving door phenomenon" in psychiatric services.
- Home-based and day hospital treatments offer a cost-effective and comprehensive solution for psychiatric care systems.