[Compulsive treatment in a psychiatry--an economic evaluation of participation in the Breakthrough model]

By use of the Breakthrough Series Collaborative a national quality project was launched in Denmark in 2004. The purpose was to improve the quality of compulsive treatment. Due to participation in the project the psychiatric ward at Herning Hospital reduced the frequency and duration of compulsive treatment significantly compared to 2003. The objective of this study was to evaluate changes in costs per discharged patient and bed-day before and after the intervention. To illustrate quality improvements beyond the purpose of the national project the consumption of antipsychotics was included in the evaluation.

Specification of working hours per discharged patient and bed-day and an average hourly rate for a nurse provide the basis for the valuation. The cost of antipsychotics is based on an average daily use per discharged patient and bed-day. The monetary unit is Danish Kroner.

The wage costs per discharged patient were 18,487 before and 19,010 after the intervention. Per bed-day the costs were 2,642 and 2,679, respectively. Medicine costs per discharged patient were 198 before and 148 after the intervention while the costs per bed-day were 28 and 21, respectively.

This evaluation of costs shows that it is possible to develop and implement quality improvements without increasing costs. A decrease in medicine costs indicates that the effect reaches further than the quality in compulsive treatment.