title: Alternatives to standard acute in-patient care in England: readmissions, service use and cost after discharge.
abstract: BACKGROUND
  Residential alternatives to standard psychiatric admissions are associated with shorter lengths of stay, but little is known about the impact on readmissions.
  
  
  OBJECTIVE
  To explore readmissions, use of community mental health services and costs after discharge from alternative and standard services.
  
  
  METHODS
  Data on use of hospital and community mental health services were collected from clinical records for participants in six alternative and six standard services for 12 months from the date of index admission.
  
  
  RESULTS
  After discharge, the mean number and length of readmissions, use of community mental health services and costs did not differ significantly between standard and alternative services. Cost of index admission and total 12-month cost per participant were significantly higher for standard services.
  
  
  CONCLUSIONS
  Shorter lengths of stay in residential alternatives are not associated with greater frequency or length of readmissions or greater use of community mental health services after discharge.
authors.affiliation: Centre for the Economics of Mental Health, Box PO24, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. s.byford@iop.kcl.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Byford
authors.forename: Jessica
authors.initials: J
authors.lastname: Sharac
authors.forename: Brynmor
authors.initials: B
authors.lastname: Lloyd-Evans
authors.forename: Helen
authors.initials: H
authors.lastname: Gilburt
authors.forename: David P J
authors.initials: DP
authors.lastname: Osborn
authors.forename: Morven
authors.initials: M
authors.lastname: Leese
authors.forename: Sonia
authors.initials: S
authors.lastname: Johnson
authors.forename: Mike
authors.initials: M
authors.lastname: Slade
mesh_terms: D000208:Acute Disease; D000328:Adult; D015331:Cohort Studies; D003155:Community Mental Health Centers / Q000191:economics* / Q000706:statistics & numerical data*; D004739:England; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012044:Regression Analysis