Abstract
We investigated the benefit of a 6-week ambulant psychiatric rehabilitation program in an ambulant psychiatric rehabilitation clinic in Vienna, Austria, from January 2014 to December 2016 by an uncontrolled repeated measures study. The potential of this intervention program was assessed by effectiveness and cost measures using suitable statistical analyses. We compared the effectiveness and cost measures of this ambulant psychiatric rehabilitation program on patients for the period of up to 12 months after discharge to the period of 12 months before admission to the intervention program based on self-reported catamnesis questionnaires. For the program’s effectiveness measures, we accounted for both psychological indices for measuring depression severity, symptom burden, and functioning to document the health improvement of patients and economy-related indices such as the number of sick leave days for patients. For the program’s cost measures, both direct tangible treatment and medication costs and indirect tangible costs based on the productivity loss measured in non-working days of the patients were considered. The results significantly demonstrated that all psychological effectiveness measures for the patients highly improved by the 6-weeks rehabilitation program and remained rather stable 12 months after discharge. We found that costs for the 6-week ambulant psychiatric rehabilitation program could be easily covered within 12 months after discharge once a total societal cost perspective was considered. Even additional total cost savings of up to over 5000 Euro could be achieved which were highest for employed patients, followed by unemployed patients receiving rehabilitation allowance due to both their high direct medication and treatment costs as well as high indirect costs for productivity loss. The most important finding was that this treatment program was especially beneficial for rehabilitation patients in earlier stages of psychiatric diseases who were still employed, indicating the need for early intervention in mental disorder.
Highlights
In the current times, humans and especially the productive workforce of countries are exposed to an unprecedented pressure resulting in overwork, burn-outs, as well as chronical and psychological diseases (World Health Organization 2013; Atroszko et al 2020; Sunkel 2021)
We investigated health care-related and economy-related effectiveness measures as well as cost-related measures of a specific 6-week multimodal ambulant psychiatric rehabilitation program in Vienna, Austria at the Zentrum für seelische Gesundheit Wien-Leopoldau from January 2014 to December 2016 as illustrated in Fig. 1
For most of the clinical effectiveness indices, we found significant improvement of the patients after discharge (D0) and even onwards (D6, discharge after 12 months (D12)) compared to admission (A) depending on the occupational status
Summary
Humans and especially the productive workforce of countries are exposed to an unprecedented pressure resulting in overwork, burn-outs, as well as chronical and psychological diseases (World Health Organization 2013; Atroszko et al 2020; Sunkel 2021). The underlying reasons for this trend are manifold such as demographical (e.g., single households, single parents, family structures), economical (e.g., low income, unemployment, state of economy), technological (e.g., rationalization, digitalization), and individual (e.g., life style, perspective of life, overreaching self-ambitions). This is why psychological diseases have sharply increased in the last years and cause a high economic burden to countries worldwide (Knapp and Wong 2020; Sunkel 2021). The impact of mental disorders is high, the health care prioritization has been still low worldwide (World Health Organization 2013; Konnopka and König 2020; Sunkel 2021)
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