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Relative efficacy of a 4-day versus a 5-day day hospital program
Marion P Olmsted1, Allan S Kaplan, Wendi Rockert
1Eating Disorder Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. Marion.olmsted@uhn.on.ca
Objective:
Day hospital treatment has demonstrated effectiveness in the treatment of eating disorders, but no information regarding the required intensity of treatment is currently available. The purpose of this study was to compare the short-term effectiveness of a 4-day versus a 5-day day hospital program.
Methods:
The study followed a sequential cohort design. Four hundred sixty-eight patients attended a 5-day program between 1985 and 1994 and 288 patients attended a 4-day program between 1995 and 2000. Weight, binging, and vomiting frequencies and psychological functioning were assessed at the beginning and at the end of treatment.
Results:
The two programs were equally effective in helping underweight patients to gain weight. However, the 5-day program was associated with higher abstinence rates for binging and vomiting and with better psychological functioning at the end of treatment. The 4-day program was more cost-effective when symptom change was considered as a percentage reduction per treatment day.
Discussion:
Overall, the 5-day program was both more effective and more costly. The relative long-term outcome of the two programs is a critical question and these data are currently being collected.