Home-based versus hospital-based care for serious mental illness: controlled cost-effectiveness study over four years

Knapp, M.R.J. and Marks, I. and Wolstenholme, J. and Beecham, J.K. and Astin, J. and Audini, B. and Connolly, J. and Watts, V. (1988) Home-based versus hospital-based care for serious mental illness: controlled cost-effectiveness study over four years. British Journal of Psychiatry, 172 (6). pp. 506-512. ISSN 0007-1250 (Print) 1472-1465 (Online). (The full text of this publication is not available from this repository)

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Abstract

<h3>Background</h3><p>The Daily Living Programme (DLP) offered intensive home-based care with problem-centres case<p><p>management for seriously mentally ill people facing crisis admission to the Maudsley Hospital, London. The cost-effectiveness of the DLP was examined over 4 years. <p><p><h3>Method</h3><p>A randomised controlled study examined cost-effectiveness of DLP versus standard in/out-patient hospital care over 20 months, followed by a randomised controlled withdrawal of half the DLP patients in to standard care. Three patient groups were compared over 45 months: DLP throughout the period, DLP for 20 months followed by standard care, and<p><p>standard care throughout. Bivariate and multivariate analyses were conducted (the latter to standardise for possible inter-sample differences stemming from sample attrition and to explore sources of within-sample variation). <p><p><h3>Results,/h3><p>The DLP was more cost-effective than control care over months 1-20, and also over the full 45 month period, but the differences between groups may have disappeared by the end of month 45. <p><p><h3>Conclusions</h3><p>The reduction of the cost-effectiveness advantage for home-based care was perhaps partly due to the attenuation of DLP care, although sample attrition left some comparisons under-powered.

Item Type: Article
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Personal Social Services Research Unit
Depositing User: Rosalyn Bass
Date Deposited: 21 May 2011 00:55
Last Modified: 30 Jul 2012 08:59
Resource URI: http://kar.kent.ac.uk/id/eprint/26916 (The current URI for this page, for reference purposes)
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