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. 2020 May 25:11:471.
doi: 10.3389/fpsyt.2020.00471. eCollection 2020.

Psychiatric Acute Day Hospital as an Alternative to Inpatient Treatment

Karsten Heekeren  1   2 , Sofia Antoniadis  1   3 , Benedikt Habermeyer  1   3 , Caitriona Obermann  1 , Matthias Kirschner  1   4 , Erich Seifritz  1 , Wulf Rössler  5 , Wolfram Kawohl  1   3
Affiliations

Psychiatric Acute Day Hospital as an Alternative to Inpatient Treatment

Karsten Heekeren et al. Front Psychiatry. .

Abstract

For the first time in the Swiss health care system, this evaluation study examined whether patients with acute psychiatric illness who were admitted for inpatient treatment could be treated in an acute day hospital instead. The acute day hospital is characterized by the possibility of direct admission of patients without preliminary consultation or waiting time and is open every day of the week. In addition, it was examined whether and to what extent there are cost advantages for day hospital treatment. Patients who were admitted to the hospital with a referral to an inpatient admission were treated randomly either fully inpatient or in the acute day hospital. As a pilot study, 44 patients were admitted to the study. Evidence of efficacy could be provided for both treatment settings based on significant reduction in psychopathological symptoms and improvement in functional level in the course of treatment. There were no significant differences between the two settings in terms of external assessment of symptoms, subjective symptom burden, functional level, quality of life, treatment satisfaction, and number of treatment days. Treatment in the day hospital was about 45% cheaper compared to inpatient treatment. The results show that acutely ill psychiatric patients of different symptom severity can be treated just as well in an acute day hospital instead of being admitted to the hospital. In addition, when direct treatment costs are considered, there are clear cost advantages for day hospital treatment.

Keywords: RCT; inpatient; psychiatric day hospital; treatment costs; treatment outcome.

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Figures

Figure 1
Figure 1
Recruitment of the study sample and randomization according to the CONSORT statement (www.consort-statement.org).
Figure 2
Figure 2
Change in psychopathology under treatment. BPRS, Brief Psychiatric Rating Scale; HoNOS, Health of the Nation Outcome Scales (means of total scores).
Figure 3
Figure 3
(A) total duration of treatment in days and treatment days (means and standard deviation). (B) direct treatment costs in swiss franc (CHF) (means and standard deviation), *significant difference (p < 0.05).
See this image and copyright information in PMC

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