Cost-effectiveness of intensive v. standard case management for severe psychotic illness. UK700 case management trial. UK700 Group
- PMID: 10974959
- DOI: 10.1192/bjp.176.6.537
Cost-effectiveness of intensive v. standard case management for severe psychotic illness. UK700 case management trial. UK700 Group
Abstract
Background: Intensive case management is commonly advocated for the care of the severely mentally ill, but evidence of its cost-effectiveness is lacking.
Aims: To investigate the cost-effectiveness of intensive compared with standard case management for patients with severe psychosis.
Method: 708 patients with psychosis and a history of repeated hospital admissions were randomly allocated to standard (case-loads 30-35) or intensive (case-loads 10-15) case management. Clinical and resource use data were assessed over two years.
Results: No statistically significant difference was found between intensive and standard case management in the total two-year costs of care per patient (means 24,550 Pounds and 22,700 Pounds, respectively, difference 1850 Pounds, 95% CI--1600 Pounds to 5300 Pounds). There was no evidence of differential effects in African-Caribbean patients or in the most disabled. Psychiatric in-patient hospital stay accounted for 47% of the total costs, but neither such hospitalisation nor other clinical outcomes differed between the randomised groups.
Conclusion: Reduced case-loads have no clear beneficial effect on costs, clinical outcome or cost-effectiveness. The policy of advocating intensive case management for patients with severe psychosis is not supported by these results.
Comment in
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Relevant training for case managers in severe mental illness.Br J Psychiatry. 2000 Dec;177:564. doi: 10.1192/bjp.177.6.564-a. Br J Psychiatry. 2000. PMID: 11102335 No abstract available.
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Assertive outreach could be cost-effective.Br J Psychiatry. 2000 Dec;177:564. doi: 10.1192/bjp.177.6.564. Br J Psychiatry. 2000. PMID: 11102337 No abstract available.
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Comments on the UK700 case management trial.Br J Psychiatry. 2000 Oct;177:370-1. doi: 10.1192/bjp.177.4.370-b. Br J Psychiatry. 2000. PMID: 11116783 No abstract available.
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Comments on the UK700 case management trial.Br J Psychiatry. 2000 Oct;177:371. doi: 10.1192/bjp.177.4.371. Br J Psychiatry. 2000. PMID: 11116784 No abstract available.
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