A CONTROLLED TRIAL OF HOME-BASED ACUTE PSYCHIATRIC-SERVICES .2. TREATMENT PATTERNS AND COSTS

Treatment records of 94 patients treated in an experimental home-based psychiatric service and 78 control patients in standard care were col lected over one year. There was a substantial reduction in in-patient care in the experimental group, both in terms of proportion admitted a nd duration of admissions, despite similar out-patient and general pra ctice care. The total treatment costs were significantly larger (> 50% ) for standard care when controlled for by diagnostic grouping. Costs were further examined by including all specialist psychiatric care, an d by excluding patients with primary diagnoses of brain damage or alco holism. Sensitivity analysis explored the effects of increasing the co st of home visits. The relative cost effectiveness of the experimental service persisted. Clinical and social outcome was similar in control and experimental groups.