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Intensive case management: a cost-effectiveness analysis

S Johnston1, G Salkeld, K Sanderson

  • 1Susan Johnston Consultancy Services, Leichhardt, New South Wales, Australia. sgjohns@ozemail.com.au

The Australian and New Zealand Journal of Psychiatry
|August 26, 1998
PubMed
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Intensive case management improved patient retention and functioning for severely mentally ill individuals. However, it incurred higher costs, with a cost-effectiveness ratio of $27,661 per patient for significant improvement.

Area of Science:

  • Mental Health Services Research
  • Health Economics
  • Psychiatric Care Management

Background:

  • Severely disabled patients with mental illness often face challenges with treatment adherence and functional improvement.
  • Optimizing case management strategies is crucial for enhancing patient outcomes and resource allocation in mental healthcare.

Purpose of the Study:

  • To compare the effectiveness and costs of intensive case management versus routine case management for severely disabled patients with mental illness.
  • To evaluate the impact on patient functioning and treatment retention.

Main Methods:

  • A randomized controlled trial was conducted with 73 patients, comparing intensive and routine case management.
  • Cost-effectiveness analysis alongside the trial, measuring functioning via the Life Skills Profile.

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  • Data collected from various health services and informal carers over 12 months.

    • Main Results:

    • Intensive case management significantly increased patient retention in treatment (p < 0.01).
    • Patients in the intensive group showed a clinically significant improvement in functioning (p < 0.05).
    • The intensive group incurred an average cost of $7745 more per patient over 12 months.

    Conclusions:

    • Intensive case management enhances treatment retention and functional outcomes for severely mentally ill patients.
    • The cost-effectiveness ratio was $27,661 per additional patient with significant functional improvement.
    • Further studies are needed to determine the optimal use of intensive case management within mental health resources.