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Related Experiment Videos

Domiciliary clinics II: a cost minimisation analysis.

Carmelo Aquilina1, David Anderson

  • 1Croydon Mental Health Services, South London and Maudsley NHS Trust, Queen's Resource Centre, Queen's Road, Croydon, London, UK. carmelo.aquilina@ntlworld.com

International Journal of Geriatric Psychiatry
|September 27, 2002
PubMed
Summary

Home-based assessments for old age psychiatry referrals are similarly cost-effective to clinic-based evaluations. Key factors influencing cost include patient non-attendance, clinician grade, and travel time for domiciliary services.

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Area of Science:

  • Geriatric Psychiatry
  • Health Economics
  • Healthcare Management

Background:

  • Old age psychiatry services manage complex patient needs.
  • Referral assessment location impacts service delivery and costs.
  • Comparing domiciliary versus clinic-based assessments is crucial for resource allocation.

Purpose of the Study:

  • To compare the cost-effectiveness of home-based versus clinic-based initial assessments for old age psychiatry referrals.
  • To identify key variables influencing the cost of psychiatric assessments.

Main Methods:

  • A comparative cost-minimization analysis was conducted.
  • Data from two old age psychiatry services (domiciliary vs. outpatient clinic) over four years were analyzed.
  • Sensitivity analysis was performed on key cost-determining variables.

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Main Results:

  • Domiciliary clinic assessments were marginally cheaper (£48) than outpatient clinic assessments (£50) per successful evaluation.
  • Non-attendance rates, clinician grade, and travel time for home visits were critical cost factors.
  • Cost-effectiveness was sensitive to these local variables.

Conclusions:

  • Initial domiciliary assessments for old age psychiatry referrals are cost-comparable to clinic-based assessments.
  • The overall cost-effectiveness of domiciliary assessments is dependent on local factors such as non-attendance and travel logistics.
  • Service providers should consider these variables when optimizing assessment strategies.