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Related Experiment Videos

Assertive community treatment in Amsterdam.

J Dekker1, W Wijdenes, Y A Koning

  • 1Mentrum, Mental Health Organisation Amsterdam.

Community Mental Health Journal
|September 19, 2002
PubMed
Summary
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This intensive case management project for severely ill patients, including those with schizophrenia, showed no improvement in daily functioning compared to regular care. However, it significantly reduced hospital bed days by 66% in the second year.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Healthcare Management

Background:

  • Intensive case management projects are crucial for managing severely ill psychiatric patients.
  • The effectiveness of such programs requires rigorous evaluation against standard care.
  • Previous research indicated potential benefits, necessitating further study.

Purpose of the Study:

  • To evaluate the effectiveness of an intensive case management project in Amsterdam.
  • To compare this new model against regular outpatient and inpatient care.
  • To assess impacts on patient functioning, compulsory admissions, and hospital bed utilization.

Main Methods:

  • A randomized clinical trial was conducted in Amsterdam, starting in 1993.
  • The study compared intensive case management with regular outpatient and inpatient care.

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  • Patients included were severely ill, with a majority diagnosed with schizophrenia.

    • Main Results:

    • The intensive case management showed no significant difference in improving everyday problems compared to regular care.
    • There was no reduction in compulsory admissions.
    • A significant decrease in hospital bed days was observed, with a 66% reduction in the second year of the program.

    Conclusions:

    • While intensive case management did not improve daily functioning over regular care, it substantially reduced healthcare costs through decreased bed days.
    • The study's data is insufficient to draw conclusions regarding suicide risk, necessitating longer follow-up.
    • Further research with extended follow-up is recommended to fully understand the long-term impacts, particularly on suicide risk.