Predicting psychiatric inpatient costs.

Ramon Sabes-Figuera,Tom K J Craig,Diana Rose,Til Wykes,Bina Sharma,Paul Mccrone,Emese Csipke

doi:10.1007/s00127-015-1152-9

Ramon Sabes-Figuera, Tom K J Craig + Show 5 more

Open Access

https://doi.org/10.1007/s00127-015-1152-9

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Abstract

PurposeA large proportion of mental health costs is inpatient care but little is known about their variation between patients. The aim of this study was to measure and identify the predictors of costs of staff contacts and activities on inpatient wards.MethodInpatients from psychiatric hospital wards in south London were interviewed in 2008 and 2009 and staff contacts and use of activities recorded over a week and costs calculated. Regression analyses identified predictors.ResultsOf 334 participants, 78 % used activities and 90 % had staff contacts. However, 41 % reported no nurse contact. Mean staff contact and activity costs were £197 and £30 per week, respectively. Staff contact costs were inversely related to age, and activity costs were higher for patients with higher levels of education. Patient satisfaction was positively associated with both costs.ConclusionsThe costs of self-reported staff contacts and use of activities account for a small amount of total inpatient costs. Patients with higher costs appeared to have higher levels of satisfaction.

Highlights

An increased focus on providing care in community settings has taken place in developed countries in recent decades
Staff contact costs were inversely related to age, and activity costs were higher for patients with higher levels of education
The costs of self-reported staff contacts and use of activities account for a small amount of total & Paul McCrone paul.mccrone@kcl.ac.uk

Summary

Introduction

An increased focus on providing care in community settings has taken place in developed countries in recent decades Despite this trend, psychiatric hospital inpatient services remain an important element of the mental health care system. The care and interventions offered on inpatient wards need to be evaluated, just as any other health care service, in terms of costs and outcomes. For evaluations of inpatient interventions it would be more helpful to identify and cost all the care inputs received whilst on a ward. This distinction is important because, even if the length of stay of two patients is the same, the use of resources might be quite different depending on activities attended and the care received. Data on the amount of care received by inpatients in terms of staff contacts and activities attended would be informative for establishing if these wards have the therapeutic ethos that is

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