title: Crisis intervention in a military population: a comparison of inpatient hospitalization and a day treatment program.
abstract: We describe transition from an inpatient psychiatric crisis intervention model to an outpatient program for nonpsychotic young adult active duty males presenting in crisis. We reviewed 300 medical records of comparable patients from each program. Demographics, clinical outcomes, and cost analysis are presented. Primary stressors were occupational and relational for both groups. Discharge diagnoses were similar with 98% patients in both groups having diagnosis adjustment disorder, personality disorder, occupational problem, or partner relational problem. Significantly more inpatients (59%) than outpatients (18%) were recommended for separation from the military for personality disorder or inability to adjust. Cost of inpatient treatment was $764 per day compared with $54.81 per day for outpatients. In the first year of operation of the outpatient program, inpatient admissions for crisis intervention in the population described declined by 195. Not only was the outpatient program much more cost-effective, it appeared to have superior clinical results.
authors.affiliation: Department of Psychiatry, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA. ghmanos@pnh10.med.navy.mil
authors.forename: Gail H
authors.initials: GH
authors.lastname: Manos
authors.forename: Janis R
authors.initials: JR
authors.lastname: Carlton
authors.forename: Paul
authors.initials: P
authors.lastname: Kolm
authors.forename: Juan C
authors.initials: JC
authors.lastname: Arguello
authors.forename: Belina R
authors.initials: BR
authors.lastname: Alfonso
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Ho
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D016009:Chi-Square Distribution; D015928:Cognitive Behavioral Therapy; D003365:Costs and Cost Analysis; D003419:Crisis Intervention / Q000379:methods*; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States