Impact of a specialized early intervention service for psychotic disorders on patient characteristics, service use, and hospital costs in a defined catchment area.

Abstract

OBJECTIVE:

To evaluate the impact of a new early intervention service for first-episode psychosis on patient characteristics, service use, and hospital costs.

METHOD:

We examined clinical records of all first admissions to hospitals of patients diagnosed with first-episode psychoses (nonaffective) over a 3-year period before and after the introduction of an early intervention service, the Prevention and Early Intervention Program for Psychosis (PEPP), in a defined catchment area. We examined demographic, clinical, and service use indices covering a 2-year period subsequent to the index admission for each patient.

RESULTS:

Patients in the post-PEPP phase were significantly younger (P < 0.01), were more often male (P < 0.05), and were less likely to be admitted to hospital with an involuntary status (P < 0.05) or with injuries (P < 0.05) at the time of their first hospital admission. Over the 2 years following the initial admission, post-PEPP patients had significantly fewer admissions to a regular psychiatric service (P < 0.001) and made significantly fewer visits to the hospital emergency department (P < 0.01). There was a significant mean reduction in costs per case of regular hospital bed use ($1028.49, SD 528.02, compared with $792.28, SD 528.02; P < 0.01) and emergency visits ($519.18, SD 353.79, compared with $353.79, SD 345.0; P < 0.01). Time series analyses followed by Chow tests failed to confirm that these cost changes could be attributed specifically to the introduction of an early intervention service.

CONCLUSION:

Introduction of a specialized early intervention program may be beneficial to patients and to the health care system. To evaluate the cost-benefit ratio of early intervention services, longer term and more detailed data may be required.

• Authors: Karen Goldberg, Ross Norman, Jeffrey S Hoch, Jeff Hoch, Norbert Schmitz, Deborah Windell, Nicole Brown, Ashok Malla
• Journal: Canadian journal of psychiatry. Revue canadienne de psychiatrie (Can J Psychiatry) Vol. 51 Issue 14 Pg. 895-903 (Dec 2006) ISSN: 0706-7437 [Print] United States
• PMID: 17249632 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Catchment Area, Health
• Female
• Health Care Costs
• Hospitalization (economics)
• Humans
• Male
• Mental Health Services (economics, statistics & numerical data)
• Middle Aged
• Ontario (epidemiology)
• Psychotic Disorders (diagnosis, economics, rehabilitation)