FC21-05 - Clinical and economical effects one year after establishing a decentralized psychiatric outpatient service

Abstract

BackgroundIntensification of outpatient psychiatric care may improve the care quality in community but also increase the total care costs in the first period as well as reduce in-patient cumulative length of stay over the medium term.ObjectiveWe investigate the economic and clinical effects of establishing of a psychiatric outpatient-service in a South-Bavarian catchment area one year before and one year after establishing.MethodsAll admitted patients in a psychiatric acute ward corresponding to the catchment area of the new outpatient- service are registered one year before establishing (2007, n = 145) and one year after (2009, n = 167). Associations between clinical, demographic and economical variables were investigated by means of multivariate regression analysis. Control variables are sex, age and psychiatric diagnostic groups.ResultsCumulative length of stay (b = −1.72, p = 0.68) and number of admissions (b = −0.10; p = 0.28) decreased, but not significantly. In-patient as well as global care costs remains the same. Costs of prescribed psychopharmacological drugs (b = 54.4; p = 0.36) and outpatient psychiatric care (b = 67.8; p = 0.15) increase obviously, but not significantly.ConclusionsAdditional implementation of an outpatient-service is not related to increase of service use costs. We found out, that in the first year there is a demand increasing effect. The effects on in-patient parameters and diagnosis groups have to be observed for the following years.