[PMH23] Deinstitutionalization of schizophrenic patients: cost-consequences and policy implication of intensive case management versus standard case management

[PMH23] Deinstitutionalization of schizophrenic patients: cost-consequences and policy implication of intensive case management versus standard case management

2001 Value in health

Llorca, PM. | Toumi, M. | Hansen, K. | Barre, S. | Francois, C. | Volume: 4, Issue: 2, Pages: 148, S,

OBJECTIVES: In France a large part of acute hospitalisation
beds are occupied by long-term hospitalisation of
schizophrenic patients. A model was developed to compare
Intensive Case Management (ICM) to Standard Case
Management (SCM) for long-term hospitalised chronic
schizophrenic patients. METHODS: A model was used
to evaluate the number of patients that are either successfully
dechronized, experiencing failure, or are readmitted
to hospital within a year for a cohort of 100 chronic
schizophrenic patients. With these figures, it was possible
to estimate the needs in terms of number of beds and employees
in the catchment area of Clermont-Ferrand in
France, for the 1st, 2nd and 3rd year after the ICM strategy
have been implemented. RESULTS: At the beginning
of the first year, 100 hospitalisation beds, 30 nurses, 10
psychologists and 5 psychiatrists were needed. After 1
year these numbers were respectively reduced to 50, 15,
10 and 2.5 due to the success of the ICM strategy. This
positive trend is also recorded for the second year of implementation.
At the end of the 3rd year a steady point
level is nevertheless reached with the model, due to the
fact that there will always be patients that can not be
dechronized; the numbers at this point will be 11 beds, 3
nurses, 1 psychologist and a half-time psychiatrist. CONCLUSIONS:
Due to the important caseload of ICM, it remains
more costly than SCM at implementation, but will
reduce cost from year 1, and be less costly than SCM
from year 3. This model can therefore evaluate the economic
impact of creating a dechronization unit in a
catchment area and make budgetary prev

https://www.doi.org/10.1046/j.1524-4733.2001.40202-209.x