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 management model on clients' use of inpatient and outpatient psychiatric care and on the costs of care.


METHODS
Ninety clients of a county mental health system who were frequent users of inpatient services were randomly assigned to either an intensive case management group, a traditional case management group, or a control group who received no particular services. Outcome variables measured over a two-year period were number of units used by clients and costs of inpatient care in county and private facilities and various types of outpatient care, including day treatment and use of an emergency psychiatric unit.


RESULTS
Clients who received intensive case management had fewer inpatient days and reduced overall costs for mental health services.


CONCLUSIONS
Assertive outreach and intensive case management can reduce hospitalizations of clients who are frequent users of inpatient care and can reduce overall mental health care costs. Mental health consumers employed as case management aides can play an important role in the delivery of mental health services, particularly with frequent users of inpatient care.
Quinlivan
R
R
Mental health case management services, San Diego County Mental Health Services, California 92110, USA.
Hough
R
R
Crowell
A
A
Beach
C
C
Hofstetter
R
R
Kenworthy
K
K
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D002140:California; D003156:Community Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D017046:Cost Savings; D003695:Delivery of Health Care / Q000191:economics; D003866:Depressive Disorder / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006300:Health Services Misuse / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D001523:Mental Disorders / Q000191:economics / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D010343:Patient Admission / Q000191:economics* / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000523:psychology; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000191:economics / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D019966:Substance-Related Disorders / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D016896:Treatment Outcome