Effectiveness and costs of acute day hospital treatment compared with conventional in-patient care: randomised controlled trial

Br J Psychiatry. 2006 Mar:188:243-9. doi: 10.1192/bjp.188.3.243.

Abstract

Background: Data on effectiveness of acute day hospital treatment for psychiatric illness are inconsistent.

Aims: To establish the effectiveness and costs of care in a day hospital providing acute treatment exclusively.

Method: In a randomised controlled trial, 206 voluntarily admitted patients were allocated to either day hospital treatment or conventional wards. Psychopathology, treatment satisfaction and subjective quality of life at discharge, 3 months and 12 months after discharge, readmissions to acute psychiatric treatment within 3 and 12 months, and costs in the index treatment period were taken as outcome criteria.

Results: Day hospital patients showed significantly more favourable changes in psychopathology at discharge but not at follow-up. They also reported higher treatment satisfaction at discharge and after 3 months, but not after 12 months. There were no significant differences in subjective quality of life or in readmissions during follow-up. Mean total support costs were higher for the day hospital group.

Conclusions: Day hospital treatment for voluntary psychiatric patients in an inner-city area appears more effective in terms of reducing psychopathology in the shortterm and generates greater patient satisfaction than conventional in-patient care, but may be more costly.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cost-Benefit Analysis
  • Day Care, Medical* / economics
  • Female
  • Health Care Costs
  • Health Services Research
  • Hospitalization* / economics
  • Humans
  • London
  • Male
  • Mental Disorders / economics
  • Mental Disorders / therapy*
  • Mental Health Services / economics
  • Mental Health Services / organization & administration*
  • Patient Satisfaction
  • Quality of Life
  • Treatment Outcome