Abstract
Objective: To investigate the cost effectiveness of joint crisis plans, a form of advance agreement for people with severe mental illness. Design: Single blind randomised controlled trial. Setting: Eight community mental health teams in southern England. Participants: 160 people with a diagnosis of psychotic illness or non-psychotic bipolar disorder who had been admitted to hospital at least once within the previous two years. Intervention: Joint crisis plan formulated by the patient, care coordinator, psychiatrist, and project worker containing contact information, details of illnesses, treatments, relapse indicators, and advance statements of preferences for care for future relapses. Control group was standardised service information. Main outcome measures: Admission to hospital; service use over 15 months. Results: Use of a joint crisis plan was associated with less service use and lower costs on average than in the standardised service information group, but differences were not significant. Total costs during follow-up were £7264 (€10 616, $13 560) for each participant with a joint crisis plan and £8359 (€12 217, $15 609) for each participant with standardised service information (mean difference £1095; 95% confidence interval -2814 to 5004). Cost effectiveness acceptability curves, used to explore uncertainty in estimates of costs and effects, suggest there is a greater than 78% probability that joint crisis plans are more cost effective than standardised service information in reducing the proportion of patients admitted to hospital. Conclusion: Joint crisis plans produced a non-significant decrease in admissions and total costs. Though the cost estimates had wide confidence intervals, the associated uncertainty suggests there is a relatively high probability of the plans being more cost effective than standardised service information for people with psychotic disorders.
Highlights
To investigate cost-effectiveness of joint crisis plans, a form of advance agreement for people with severe mental illness [1,2].gest there is a greater than 78% probability that Joint Crisis Plans are more cost-effective than the standardized service information in reducing the proportion of patients admitted to hospital
Gest there is a greater than 78% probability that Joint Crisis Plans are more cost-effective than the standardized service information in reducing the proportion of patients admitted to hospital
Intervention: The Joint Crisis Plan was formulated by the patient, care co-ordinator, psychiatrist, and project worker, containing contact information, details of illnesses, treatments, relapse indicators, and advance statements of preferences for care for future relapses
Summary
To investigate cost-effectiveness of joint crisis plans, a form of advance agreement for people with severe mental illness [1,2]. Gest there is a greater than 78% probability that Joint Crisis Plans are more cost-effective than the standardized service information in reducing the proportion of patients admitted to hospital
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.