Cost-outcome analysis and service planning in a CMHC

The outcome of outpatient treatment of 497 children and 396 adults at a large community mental health and mental retardation center was associated with cost of services and with clients' number of sessions, length of stay, and density of treatment. The cost of one hour of outpatient services averaged $53.15 for adults and $52.32 for children. Treatment outcome was not directly related to cost of treatment, but clients who regressed used more resources than did clients whose conditions remained the same. Adults who improved were in therapy for a shorter period than were adults who became worse, but they were treated more times per month. The cost-outcome analysis methodology described here can be useful in forecasting the effects of budget reductions on case mix and treatment outcome, in developing effective service models for various funding levels, and in identifying optimal caseloads.