Cost-effectiveness of community psychiatric nurse or out-patient psychiatrist care of neurotic patients.
In a prospective controlled investigation chronic patients, the majority with neurotic conditions, were randomly allocated either to community psychiatric nurses (CPN) as the main therapist or to routine out-patient psychiatrist follow-up. There was no statistically significant difference in the mean public expenditure for the two modes of care. The direct costs of psychiatric care comprised a small proportion of total public expenditure and were initially greater in the nursing group. Subsequently, and over the whole 18-month study period, nursing was the cheaper option in terms of these direct costs. Clinical and social outcomes were comparable in both follow-up groups. Consumer satisfaction was significantly greater among CPN patients. On balance, these results confirm the benefit of community psychiatric nursing for this patient group.
D000293:Adolescent; D000328:Adult; D000368:Aged; D003156:Community Mental Health Services / Q000191:economics; D003258:Consumer Behavior; D003362:Cost-Benefit Analysis / Q000379:methods; D004739:England; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D008875:Middle Aged; D009497:Neurotic Disorders / Q000191:economics / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D011568:Psychiatric Nursing / Q000191:economics*; D011570:Psychiatry / Q000191:economics*; D011897:Random Allocation