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.