Factors associated with successful psychiatric intensive home treatment - a quasi-experimental study

With more and more Home Treatment (HT) teams being implemented worldwide as well as high variations in models and intensity of care and target groups, there is a need to look at factors associated with its success and relative effectiveness compared to inpatient treatment (IT). For doing so, we used data from the quasi-experimental evaluation of the German highly regulated model of intensive HT (IHT).

Within a propensity-score matched study we compared 200 patients treated by IHT in ten psychiatric centers to 200 inpatients and assessed inpatient re-admission rate and days spent in hospital within the 12-months follow-up time. We used a set of clinical and sociodemographic variables within a multivariate regression model to evaluate the influence of variables affecting the relative effectiveness of IHT versus IT.

Controlling for diagnosis, age, treatment history, marital and employment status, IHT was more effective than IT for women compared to men in avoiding readmissions. Furthermore, IHT was more effective for people with less impairment and those with either no inpatient treatment history or a high number of previous hospitalizations in the last two years.

IHT might be more beneficial in women due to their stronger preference or advantages in involving community resources among women. IHT might be suitable for those with less severe psychiatric crises but also for high utilizers to stop revolving door patterns.