A Two-Year Follow-Up of a Comparative Trial of the Cost-Effectiveness of Home and Hospital Psychiatric Treatment

Abstract

The manpower and operating cost of home-based treatment was compared with the manpower and operating cost of hospital-based treatment during the second year and at the end of two years of treatment. Of the 155 patients destined to receive inpatient treatment, 76 were randomly assigned to home treatment, 79 to hospital treatment. The two groups were similar as to important social, demographic, and clinical characteristics, including psychiatric diagnosis. The manpower and operating cost of treatment, measured in two ways, was similar in the two groups during the second year. However, over the 2-year period hospital-based treatment of patients in each of the three diagnostic groups was more expensive than home-based treatment. Also, regardless of which treatment was given, the cost of treating schizophrenics was higher than the cost of treating manic-depressives which, in turn, was higher than the cost of treating individuals with depressive neurosis. Treatment failures were discussed. Over the 2-year period, failures in home-based treatment accounted for 39.1% of the total manpower and operating cost of home-based treatment, calculated according to Cost Model 1, and for 67.1% of the cost calculated according to Cost Model 2. The concept of failure in hospital-based treatment is also discussed.