Economic evaluation of a crisis resolution service: a randomised controlled trial.
OBJECTIVE
The use of specialised services to avoid admission to hospital for people experiencing mental health crises is seen as an integral part of psychiatric services in some countries. The aim of this paper is to assess the impact on costs and cost-effectiveness of a crisis resolution team (CRT).


METHODS
Patients who were experiencing mental health crises sufficient for admission to be considered were randomised to either care provided by a CRT or standard services. The primary outcome measure was inpatient days over a six-month follow-up period. Service use was measured, costs calculated and cost-effectiveness assessed.


RESULTS
Patients receiving care from the CRT had non-inpatient costs pounds sterling 768 higher than patients receiving standard care (90% CI, pounds sterling 153 to pounds sterling 1375). With the inclusion of inpatient costs the costs for the CRT group were pounds sterling 2438 lower for the CRT group (90% CI, pounds sterling 937 to pounds sterling 3922). If one less day spent as an inpatient was valued at pounds sterling 100, there would be a 99.5% likelihood of the CRT being cost-effective.


CONCLUSIONS
This CRT was shown to be cost-effective for modest values placed on reductions in inpatient stays.
McCrone
Paul
P
Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK. p.mccrone@iop.kcl.ac.uk
Johnson
Sonia
S
Nolan
Fiona
F
Pilling
Stephen
S
Sandor
Andrew
A
Hoult
John
J
McKenzie
Nigel
N
Thompson
Marie
M
Bebbington
Paul
P
D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics*