An intensive multimodal group programme for patients with psychotic disorders at risk of rehospitalization: a controlled intervention study

Autor: Arthur R. Van Gool, Mark H. de Jong, André I. Wierdsma, Cornelis L. Mulder
Přispěvatelé: Psychiatry
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Care as usual
Psychiatric admission
lcsh:RC435-571
Assertive community treatment
medicine.medical_treatment
Psychotic disorder
Group psychotherapy
Mental healthcare
03 medical and health sciences
0302 clinical medicine
Group (periodic table)
lcsh:Psychiatry
Severe mental illness
medicine
Humans
Community mental healthcare
Spectrum disorder
030212 general & internal medicine
Netherlands
Adult patients
business.industry
Length of Stay
Middle Aged
Combined Modality Therapy
Intervention studies
Community Mental Health Services
Group therapy
030227 psychiatry
Hospitalization
Psychiatry and Mental health
Treatment Outcome
Psychotic Disorders
Research Design
Mental healthcare costs
Psychotherapy
Group
Physical therapy
Female
business
Program Evaluation
Research Article
Zdroj: BMC Psychiatry, Vol 19, Iss 1, Pp 1-6 (2019)
BMC Psychiatry
BMC Psychiatry, 19(1):241. BioMed Central Ltd.
ISSN: 1471-244X
DOI: 10.1186/s12888-019-2229-x
Popis: Background On the basis of earlier experiences in Germany and England, we developed an intensive multimodal group programme (FACT Plus) for psychotic-spectrum patients. By combining it with regular Flexible Assertive Community Treatment (FACT) (care as usual), we intended to reduce psychiatric rehospitalizations and mental healthcare costs. Methods We included adult patients (>18 years) with a psychotic spectrum disorder who had had at least one psychiatric admission in the 2 years before inclusion. FACT Plus was delivered weekly for 9 months. The intervention group was recruited in northern Rotterdam (the Netherlands), and the control group was recruited in southern Rotterdam. The primary outcome measure was length of stay (LOS) and the secondary outcome measures were mental healthcare costs and compulsory admissions. Results We included 52 patients in the intervention group and 61 patients in the control group. During the 12-month observation period, the mean LOS per patient was 15.2 (intervention group) and 34.6 (control group). This represents a difference of 19.4 days (56.1%). This result was statistically significant (B = −.859, SE = .497, p = .042) in a regression model correcting for baseline differences between the groups. Mean total mental healthcare costs per patient were €21,098 in the intervention group) versus €25,054 in the control group, a difference of about €4000 per patient (16%). In addition, there were zero compulsory admissions in the intervention group and nine in the control group. Conclusions After the addition of FACT Plus to regular FACT, psychiatric LOS was substantially lower in the intervention group than in the control group. This result was accompanied by a limited reduction in mental healthcare costs.
Databáze: OpenAIRE
Externí odkaz: