title: [Cost-effectiveness of needs-oriented discharge planning in high utilizers of mental health care].
abstract: OBJECTIVE
  To establish the cost-effectiveness of needs-oriented discharge planning in high utilizers of mental health services.
  
  
  METHODS
  As part of a multicenter RCT (n = 458), costs were measured via the German version of the "Client Sociodemographic and Service Receipt Inventory" (CSSRI-EU), and the EQ-5 D was used to ascertain QALYs. Cost-effectiveness analysis included deriving incremental cost-effectiveness ratios (ICERs) and plotting them onto the cost-effectiveness plane as well as examining cost-effectiveness acceptability taking into account willingness-to-pay.
  
  
  RESULTS
  During an 18-month period after discharge from inpatient psychiatric treatment, neither total direct and indirect costs (44,278 € vs. 43,302 €) nor quality-adjusted life years (0.960 vs. 0.958 QALYs) significantly differed by participant allocation to intervention or control groups. Also inspection of ICERs showed that the intervention had no economic advantage over standard care.
  
  
  CONCLUSIONS
  The intervention is no cost-effective alternative to standard care. Future studies aiming to improve organization of mental care should be considerate of institutional context.
authors.affiliation: Klinik für Psychiatrie und Psychotherapie II der Universität Ulm, Günzburg. bernd.puschner@bkhguenzburg.de
authors.forename: Bernd
authors.initials: B
authors.lastname: Puschner
authors.forename: Ildiko
authors.initials: I
authors.lastname: Baumgartner
authors.forename: Sabine
authors.initials: S
authors.lastname: Loos
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Völker
authors.forename: Meike
authors.initials: M
authors.lastname: Ramacher
authors.forename: Katja
authors.initials: K
authors.lastname: Sohla
authors.forename: Julia
authors.initials: J
authors.lastname: Grempler
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kilian
mesh_terms: D000328:Adult; D032982:Contracts / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D005544:Forecasting; D005858:Germany; D006300:Health Services Misuse / Q000191:economics* / Q000517:prevention & control* / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics* / Q000458:organization & administration* / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000191:economics*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000191:economics; D017064:Process Assessment, Health Care; D011785:Quality Assurance, Health Care / Q000191:economics* / Q000458:organization & administration* / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D014600:Utilization Review / Q000706:statistics & numerical data