Economic impact of crisis intervention in emergency psychiatry: a naturalistic study.
OBJECTIVE
This is a naturalistic study comparing the outcomes of all emergency psychiatric interventions in the Hospital Center of Luxembourg during two periods of six months each, before and after the introduction of a crisis intervention program. The aim of the study was to investigate the clinical and economic impact of crisis intervention on psychiatric emergency admissions.


METHODS
All subjects admitted to the emergency psychiatric unit during the two study periods were considered for participation. Data were collected retrospectively and comparisons were made between patients before (September 1, 2001 to February 28, 2002) and after (September 1, 2002 to February 28, 2003) crisis intervention programs were established.


RESULTS
A comparison between the two patient groups demonstrated a significant decrease in the rate of voluntary hospitalizations after crisis intervention, and a significant increase in the number of patients with subsequent outpatient consultations. The cost increase due to ambulatory follow-ups was widely compensated for by the cost decrease due to hospitalization avoidance.


CONCLUSIONS
These preliminary findings suggest that crisis intervention leads to a shift from hospitalization to outpatient psychotherapeutic management in emergency psychiatric services, which has a significant economic impact.
Damsa
Cristian
C
Emergency and Crisis Intervention Unit, University of Geneva Psychiatric Center, Switzerland. c.damsa@bluewin.ch
Hummel
Christopher
C
Sar
Vedat
V
Di Clemente
Thierry
T
Maris
Susanne
S
Lazignac
Coralie
C
Massarczyk
Odile
O
Pull
Charles
C
D000328:Adult; D003419:Crisis Intervention / Q000191:economics*; D004637:Emergency Services, Psychiatric / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000534:rehabilitation*; D008875:Middle Aged; D011570:Psychiatry / Q000191:economics*