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Multisite experimental cost study of intensive psychiatric community care
1VA Northeast Program Evaluation Center, West Haven, CT 06516, USA.
Schizophrenia Bulletin
|January 1, 1995
Summary
Intensive Psychiatric Community Care (IPCC) programs reduced inpatient use by 33% and costs by 20% for high-need veterans. Savings were significant at neuropsychiatric sites but varied at general medical sites.
Area of Science:
- Health Services Research
- Psychiatric Care
- Cost-Effectiveness Analysis
Background:
- High hospital utilization among psychiatric patients presents a significant cost burden.
- Intensive Psychiatric Community Care (IPCC) models aim to manage complex patient needs outside traditional hospital settings.
Purpose of the Study:
- To evaluate the cost-effectiveness of Intensive Psychiatric Community Care (IPCC) programs compared to standard care for high hospital users within the Department of Veterans Affairs (VA).
Main Methods:
- A 2-year experimental cost study involving 10 VA medical centers.
- Random assignment of high hospital users to either IPCC or standard VA care.
- Tracking of VA health care service usage and costs using national computerized data.
Main Results:
- IPCC programs reduced inpatient service usage by 33% (89 days) and overall costs by 20% ($15,556) per patient.
- Cost reductions were more substantial at neuropsychiatric (NP) sites (-$33,295) compared to general medical and surgical (GMS) sites (+$6,273).
- Cost savings were observed in veterans over 45 and those with high prior inpatient use, irrespective of site type.
Conclusions:
- IPCC is a cost-effective intervention for high-need psychiatric patients, particularly at NP sites.
- Targeting specific veteran subgroups (older, high-utilizers) enhances cost-saving potential.
- Full implementation of IPCC programs is crucial for achieving optimal cost-effectiveness outcomes.