SERVICE UTILIZATION AND COSTS OF CARE FOR SEVERELY MENTALLY-ILL CLIENTS IN AN INTENSIVE CASE-MANAGEMENT PROGRAM

Objective: The study evaluated the effects of an intensive case manage ment model on clients' use of inpatient and outpatient psychiatric car e and on the costs of care. Methods: Ninety clients of a county mental health system who were frequent users of inpatient services were rand omly assigned to either an intensive case management group, a traditio nal case management group, or a control group who received no particul ar services, Outcome variables measured over a two-year period were nu mber of units used by clients and costs of inpatient care in county an d private facilities and various types of outpatient care, including d ay treatment and use of an emergency psychiatric unit. Results: Client s who received intensive case management had fewer inpatient days and reduced overall costs for mental health services. Conclusions: Asserti ve outreach and intensive case management can reduce hospitalizations of clients who are frequent users of inpatient care and can reduce ove rall mental health care costs. Mental health consumers employed as cas e management aides can play an important role in the delivery of menta l health services, particularly with frequent users of inpatient care.