[Cost-effectiveness of needs-oriented discharge planning in high utilizers of mental health care]

Abstract

Objective: To establish the cost-effectiveness of needs-oriented discharge planning in high utilizers of mental health services.

Methods: As part of a multicenter RCT (n = 458), costs were measured via the German version of the "Client Sociodemographic and Service Receipt Inventory" (CSSRI-EU), and the EQ-5 D was used to ascertain QALYs. Cost-effectiveness analysis included deriving incremental cost-effectiveness ratios (ICERs) and plotting them onto the cost-effectiveness plane as well as examining cost-effectiveness acceptability taking into account willingness-to-pay.

Results: During an 18-month period after discharge from inpatient psychiatric treatment, neither total direct and indirect costs (44,278 € vs. 43,302 €) nor quality-adjusted life years (0.960 vs. 0.958 QALYs) significantly differed by participant allocation to intervention or control groups. Also inspection of ICERs showed that the intervention had no economic advantage over standard care.

Conclusions: The intervention is no cost-effective alternative to standard care. Future studies aiming to improve organization of mental care should be considerate of institutional context.