title: Cost-effectiveness of a rapid response team intervention for suicidal youth presenting at an emergency department.
abstract: OBJECTIVE
  To investigate the cost-effectiveness of a rapid response team (RRT), compared with usual care (UC), for treating suicidal adolescents.
  
  
  METHODS
  Suicidal adolescents (n = 286) presenting at an emergency department were enrolled in a trial to compare UC with enhanced outpatient care provided by an RRT of health professionals. Functioning (Child Global Assessment Scale) and suicidality (Spectrum of Suicidal Behavior Scale) scores were measured at baseline and 6 months later. Resource use and cost data were collected from several sources during the same period.
  
  
  RESULTS
  As previously reported, there was no statistically or clinically significant difference in either functioning or suicidality between the groups. Costs of the RRT were lower by $1886, thus -$1886 (95% CI -$4238 to $466), from the perspective of the treating hospital, and by $991, thus -$991 (95% CI -$5580 to $3598), from the perspective of society. If decision makers are not willing to pay for any improvement in functioning or suicidality, the RRT has a 95% probability of being cost-effective from the perspective of the treating hospital. From the point of view of society, the probability of the intervention being cost-effective is about 70% for functioning and 63% for suicidality. The difference between the 2 perspectives is mainly attributable to the cost of hospitalizations outside the treating hospital.
  
  
  CONCLUSIONS
  An RRT intervention appears to be cost-effective, compared with UC, from the point of view of the treating hospital, but there is no difference from the point of view of society.
authors.affiliation: Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Research Scientist, Douglas Mental Health University Institute, Montreal, Quebec.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Latimer
authors.affiliation: Student, Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec.
authors.forename: Geneviéve
authors.initials: G
authors.lastname: Garièpy
authors.affiliation: Associate Professor of Clinical Psychiatry and Pediatrics, Division of Child Psychiatry, McGill University, Montreal, Quebec; Director, Emergency Psychiatric Service, Children's Hospital, McGill University Health Centre, Montreal, Quebec.
authors.forename: Brian
authors.initials: B
authors.lastname: Greenfield
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics; D002648:Child; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital / Q000191:economics*; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data; D057209:Hospital Rapid Response Team / Q000191:economics*; D006776:Hospitals, Pediatric / Q000191:economics; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009313:National Health Programs / Q000191:economics*; D011247:Pregnancy; D011792:Quebec; D013405:Suicide / Q000191:economics* / Q000523:psychology; D013406:Suicide, Attempted / Q000191:economics* / Q000517:prevention & control* / Q000523:psychology; D014600:Utilization Review; D000092864:Suicide Prevention