Healthcare in schizophrenia: effectiveness and progress of a redesigned care network.
BACKGROUND
The aim of this study was designed to investigate the care-effectiveness of different healthcare models for schizophrenic patients and the impact of it on caregivers.


METHODS
Sample cases were randomly selected from southern Taiwan, 257 patients in redesigned care network, including a general hospital, a chronic ward, 10 outpatient clinics, and multialternative community programs, was compared to 247 patients in other traditional healthcare provider that were utilized as the control group. The quality of life (QOL) questionnaire and the Chinese health questionnaire (CHQ) were used.


RESULTS
The controls had longer duration of illness (p = 0.001) and were older (p = 0.004). The average resource utilization in the study group (US$ 2737/year, per case) was higher than the control group (US$ 2041) (t = 7.91, p < 0.001). For the study group, the average length of stay was shorter, but the admission rate was higher. The QOL of the patients in the study group was better than that of the controls (p = 0.01). The family burden of the study group was lower (p = 0.035) and the score of general health questionnaire higher (p = 0.019).


CONCLUSIONS
We found that patients in the redesigned care network had a better QOL, lower family burden, decreased days of hospital stay, higher medical resource utilization and less frequent admission to a hospital, and the caregivers had better mental health. Although the costs were higher, the continued care network was more helpful in providing comprehensive mental illness services.
Tzeng
Dong-Sheng
DS
Department of Psychiatry, Military Kaohsiung General Hospital, Kaohsiung, Taiwan. tzengds@seed.net.tw
Lian
Li-Chiu
LC
Chang
Chin-Un
CU
Yang
Chun-Yuh
CY
Lee
Gian-Tin
GT
Pan
Peter
P
Lung
For-Wey
FW
D000328:Adult; D019058:Community Networks / Q000458:organization & administration*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated; D005260:Female; D006297:Health Services Accessibility; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D016730:Program Development; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D011787:Quality of Health Care; D011788:Quality of Life; D012559:Schizophrenia / Q000517:prevention & control / Q000628:therapy*; D055502:Secondary Prevention; D011795:Surveys and Questionnaires; D013624:Taiwan; D013997:Time Factors
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