THE PATTERN-OF-CARE MODEL - A TOOL FOR PLANNING COMMUNITY MENTAL-HEALTH-SERVICES

In periods of change, psychiatric services must project outcomes of de cisions about service innovations and reductions, including budgetary implications. To support such decision making, a public-sector psychia tric service in Melbourne, Victoria, Australia, developed a modeling t ool that combines data from its service activity database and budgetar y information with modeling techniques based on use of a spreadsheet. The model is based on clients' use of three major service components: the inpatient unit, continuing clinical care and consultancy services, and crisis assessment and treatment set-vices. It classifies clients according to patterns of care-that is, whether they used one, two, or three of the components, in various combinations. The authors report s ervice use and financial data derived from the model for the financial year 1992-1993. They describe two scenarios for using the model to pr oject changes in patterns of care and costs when new services are impl emented. Such a model can clarify costs, including opportunity costs, of management decisions and facilitate participation of senior clinici ans in active service planning within the realities of budgetary const raints.