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.
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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)
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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)
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