title: A comparison of the cost-effectiveness of hospital-based home care with that of a conventional outpatient follow-up for patients with mental illness.
abstract: The purpose of this study was to compare the outcomes of a hospital-based home-care model with those of a conventional outpatient follow-up for mentally ill patients in Taiwan by means of cost-effectiveness analysis. The study design was a two group posthoc design. We interviewed 40 mentally ill patients who were followed up in the psychiatric outpatient department. Another 40 mentally ill patients who participated in a hospital based home care program were also interviewed. The outcome measures we used for interviews were disease maintenance behavior, psychotic symptoms, social function, service satisfaction, and cost. The cost for each patient was the sum of costs for all direct mental health services. The cost-effectiveness ratio showed that the costs of the hospital-based home care model (4.3) were lower than those of conventional outpatient follow-up (13.5) and that over a one-year period, the hospital-based home care model was associated with improvements in mental conditions, social functional outcomes, and service satisfaction. The improved outcomes and the lower costs in the hospital-based home care program support the view that it is the most cost-effective of the two. Policy makers may consider this analysis as they allocate resources and develop policy for the care of mentally ill patients.
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, and Taipei Medical University, Taiwan.
authors.forename: Sing-Ling
authors.initials: SL
authors.lastname: Tsai
authors.forename: Mei-Bih
authors.initials: MB
authors.lastname: Chen
authors.forename: Teresa J C
authors.initials: TJ
authors.lastname: Yin
mesh_terms: D000328:Adult; D000359:Aftercare / Q000191:economics* / Q000523:psychology; D000553:Ambulatory Care / Q000191:economics*; D003152:Community Health Nursing / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D018575:Home Care Services, Hospital-Based / Q000191:economics*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000451:nursing* / Q000523:psychology; D008875:Middle Aged; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D015397:Program Evaluation; D011568:Psychiatric Nursing / Q000191:economics*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012919:Social Behavior; D011795:Surveys and Questionnaires; D013624:Taiwan