Community psychiatric-nurse teams - cost-effectiveness of intensive support versus generic care

Background. Part of the community psychiatric nurse (CPN) service was reorganised into a community support team (CST), with staff acting as case managers. An economic evaluation ran parallel to the comparison with generic CPN care. Method. Eighty-two clients were randomly allocated to experimental and control groups. Costs were comprehensively measured over a pre-referral period (three months), and then at 6, 12, and 18 months. Results. The economic evaluation found a cost difference between the groups. Generic group costs averaged pound 89 per patient per week more than CST group costs. The difference was only significant for the first six months. Changes in the burden of cost across agencies were observed. Conclusions. Although CPN inputs and costs were higher for the CST group, there was a significant short-term reduction in total cost. Beyond the short term, the CST did not confer cost or cost-effectiveness advantages.