PMID- 20679274
OWN - NLM
STAT- MEDLINE
DCOM- 20140609
LR  - 20191210
IS  - 0960-5371 (Print)
IS  - 0960-5371 (Linking)
VI  - 53
DP  - 2010 Aug
TI  - Alternatives to standard acute in-patient care in England: short-term clinical 
      outcomes and cost-effectiveness.
PG  - s14-9
LID - 10.1192/bjp.bp.110.081059 [doi]
AB  - BACKGROUND: Outcomes following admission to residential alternatives to standard 
      in-patient mental health services are underresearched. AIMS: To explore 
      short-term outcomes and costs of admission to alternative and standard services. 
      METHOD: Health of the Nation Outcome Scales (HoNOS), Threshold Assessment Grid 
      (TAG), Global Assessment of Functioning (GAF) and admission cost data were 
      collected for six alternative services and six standard services. RESULTS: All 
      outcomes improved during admission for both types of service (n = 433). Adjusted 
      improvement was greater for standard services in scores on HoNOS (difference 
      1.99, 95% CI 1.12-2.86), TAG (difference 1.40, 95% CI 0.39-2.51) and GAF 
      functioning (difference 4.15, 95% CI 1.08-7.22) but not GAF symptoms. Admissions 
      to alternatives were 20.6 days shorter, and hence cheaper (UK pound3832 v. 
      pound9850). Standard services cost an additional pound2939 per unit HoNOS 
      improvement. CONCLUSIONS: The absence of clear-cut advantage for either type of 
      service highlights the importance of the subjective experience and longer-term 
      costs.
FAU - Slade, M
AU  - Slade M
AD  - Health Service and Population Research Department, Box PO29, Institute of 
      Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 
      8AF, UK. m.slade@iop.kcl.ac.uk.
FAU - Byford, S
AU  - Byford S
FAU - Barrett, B
AU  - Barrett B
FAU - Lloyd-Evans, B
AU  - Lloyd-Evans B
FAU - Gilburt, H
AU  - Gilburt H
FAU - Osborn, D P J
AU  - Osborn DP
FAU - Skinner, R
AU  - Skinner R
FAU - Leese, M
AU  - Leese M
FAU - Thornicroft, G
AU  - Thornicroft G
FAU - Johnson, S
AU  - Johnson S
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Br J Psychiatry Suppl
JT  - The British journal of psychiatry. Supplement
JID - 9001294
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Cluster Analysis
MH  - Cohort Studies
MH  - Community Mental Health Centers/*economics
MH  - Cost-Benefit Analysis
MH  - England
MH  - Female
MH  - Hospitalization/*economics/statistics & numerical data
MH  - Humans
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Mental Disorders/economics/*therapy
MH  - Outcome Assessment, Health Care/economics/*statistics & numerical data
MH  - Regression Analysis
MH  - Time Factors
EDAT- 2010/08/04 06:00
MHDA- 2014/06/10 06:00
CRDT- 2010/08/04 06:00
PHST- 2010/08/04 06:00 [entrez]
PHST- 2010/08/04 06:00 [pubmed]
PHST- 2014/06/10 06:00 [medline]
AID - 197/Supplement_53/s14 [pii]
AID - 10.1192/bjp.bp.110.081059 [doi]
PST - ppublish
SO  - Br J Psychiatry Suppl. 2010 Aug;53:s14-9. doi: 10.1192/bjp.bp.110.081059.