| Cost-effectiveness of intensive v. standard case management for severe psychotic illness. UK700 case management trial. UK700 Group. | |
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MedLine Citation:
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PMID: 10974959 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Intensive case management is commonly advocated for the care of the severely mentally ill, but evidence of its cost-effectiveness is lacking. AIMS: To investigate the cost-effectiveness of intensive compared with standard case management for patients with severe psychosis. METHOD: 708 patients with psychosis and a history of repeated hospital admissions were randomly allocated to standard (case-loads 30-35) or intensive (case-loads 10-15) case management. Clinical and resource use data were assessed over two years. RESULTS: No statistically significant difference was found between intensive and standard case management in the total two-year costs of care per patient (means 24,550 Pounds and 22,700 Pounds, respectively, difference 1850 Pounds, 95% CI--1600 Pounds to 5300 Pounds). There was no evidence of differential effects in African-Caribbean patients or in the most disabled. Psychiatric in-patient hospital stay accounted for 47% of the total costs, but neither such hospitalisation nor other clinical outcomes differed between the randomised groups. CONCLUSION: Reduced case-loads have no clear beneficial effect on costs, clinical outcome or cost-effectiveness. The policy of advocating intensive case management for patients with severe psychosis is not supported by these results. |
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Authors:
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The British journal of psychiatry : the journal of mental science Volume: 176 ISSN: 0007-1250 ISO Abbreviation: Br J Psychiatry Publication Date: 2000 Jun |
Date Detail:
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Created Date: 2000-09-27 Completed Date: 2000-09-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0342367 Medline TA: Br J Psychiatry Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 537-43 Citation Subset: IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Cost-Benefit Analysis Follow-Up Studies Hospitalization / economics* Humans Intensive Care / economics* Middle Aged Psychotic Disorders / economics*, ethnology, therapy Treatment Outcome West Indies / epidemiology |
| Comments/Corrections | |
Comment In:
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Br J Psychiatry. 2000 Dec;177:564
[PMID:
11102337
]
Br J Psychiatry. 2000 Dec;177:564 [PMID: 11102335 ] Br J Psychiatry. 2000 Oct;177:370-1 [PMID: 11116783 ] Br J Psychiatry. 2000 Oct;177:371 [PMID: 11116784 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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