The Cost of Preventing Stigma by Hospitalizing Soldiers in a General Hospital Instead of a Psychiatric Hospital

Abstract

Hospitalization costs are lower in psychiatric hospitals than in psychiatric departments of general hospitals. However, soldiers hospitalized in psychiatric hospitals are subject to the stigma associated with mental illness. The goal of this study was to examine the financial costs of preventing such stigma by hospitalizing soldiers in psychiatric departments of general hospitals, rather than less expensive psychiatric hospitals. Another goal was to find ways to reduce hospitalization costs, taking into consideration the consequences of the stigma for patients and their families. Costs, medical data, and demographic data were gathered from records of soldiers hospitalized for psychiatric illness. The most expensive causes of hospitalization were determined (acute psychotic state and adjustment disorders), and the characteristics of a soldier most likely to encounter psychosis were described. Recommendations include rerouting patients from hospitalization to ambulatory day care, when possible, and from general to psychiatric hospitals. We also recommend adopting a psychiatric diagnosis-related group price list to standardize sums paid per diagnosis and creating a system for considering, on a case-by-case basis, early discharge of soldiers with psychotic disorders during the stressful first half-year of military service.