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Leaving hospital II: the cost-effectiveness of community care for former long-stay psychiatric hospital patients
- Authors:
- BEECHAM Jennifer, et al
- Journal article citation:
- Journal of Mental Health, 5(4), October 1996, pp.379-394.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The planning and delivery of community based care for people with long-term mental health problems has important resource consequences. Some of the main questions about the replacement of long-term hospital services with community-based care relate to the comparative costs of care in the two locations and resource needs of people discharged. This article looks at a research programme evaluating community care in Northern Ireland. It discusses the quality of life and welfare of former hospital residents before and after their discharge to community services and the costs of service provision. Results found community care to be cheaper than hospital care and that the new service was a cost-effective alternative as there was little change in clients' welfare. However, analysis of the variations in community care costs found only weak associations with clients' personal characteristics and needs, and found no link between differential spending and differential outcomes
Variations in the costs of child and adolescent psychiatric in-patient units
- Authors:
- BEECHAM Jennifer, et al
- Journal article citation:
- British Journal of Psychiatry, 18(9), September 2003, pp.220-225.
- Publisher:
- Cambridge University Press
Child and adolescent in-patient care is a highly specialised service, ideally requiring planning at a national level, but there are no routine data collections specifically for these services. The aim was to estimate unit costs for child and adolescent psychiatric in-patient units and to analyse the variations in costs between units. Data collection alongside a national survey with cost estimations guided byprinciples drawn from economic theory. Bivariate and multivariate analyses are employed to identify cost influences. Fifty-eight units could provide sufficient data to allow calculation of the cost per in-patient day; mean=£197 (s.d.=71.6; 1999–2000 prices). The management sector, type of provision, number of rooms, capacity and location explained nearly half of the cost variation. Child and adolescent psychiatric in-patient units are an expensive resource, with personnel absorbing two-thirds of the total costs. Costs per in-patient day vary fourfold and the exploration of cost variations can inform commissioning strategies.