Community psychiatric nurse teams: cost-effectiveness of intensive support versus generic care.
BACKGROUND
Part of the community psychiatric nurse (CPN) service was reorganised into a community support team (CST), with staff acting as case managers. An economic evaluation ran parallel to the comparison with generic CPN care.


METHODS
Eighty-two clients were randomly allocated to experimental and control groups. Costs were comprehensively measured over a pre-referral period (three months), and then at 6, 12, and 18 months.


RESULTS
The economic evaluation found a cost difference between the groups. Generic group costs averaged 89 pounds per patient per week more than CST group costs. The difference was only significant for the first six months. Changes in the burden of cost across agencies were observed.


CONCLUSIONS
Although CPN inputs and costs were higher for the CST group, there was a significant short-term reduction in total cost. Beyond the short term, the CST did not confer cost or cost-effectiveness advantages.
McCrone
P
P
Institute of Psychiatry, London.
Beecham
J
J
Knapp
M
M
D000328:Adult; D000359:Aftercare / Q000191:economics*; D003152:Community Health Nursing / Q000191:economics*; D003191:Comprehensive Health Care / Q000191:economics; D003361:Cost Allocation; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007182:Income; D008297:Male; D008329:Managed Care Programs / Q000191:economics; D008875:Middle Aged; D009746:Nursing, Team / Q000191:economics*; D010359:Patient Readmission / Q000191:economics; D011568:Psychiatric Nursing / Q000191:economics*; D011618:Psychotic Disorders / Q000191:economics* / Q000451:nursing / Q000534:rehabilitation; D012050:Rehabilitation, Vocational / Q000191:economics; D012944:Social Support