PW01-126 - In-patient versus home based models of acute mental illness care in adults: direct cost comparison from provider's perspective

2010 ◽  
Vol 25 ◽  
pp. 1542
Author(s):  
A. Raji ◽  
A. Jackson
Keyword(s):  
Mental Illness ◽  
Direct Cost ◽  
Cost Comparison ◽  
Home Based

Effectiveness of a Home Based Training Program on Caregivers Knowledge in Managing Aggressive Behavior of Patients With Mental Illness

2021 ◽  
pp. 108482232110394
Author(s):  
Kusum Lata ◽  
T. K Ajesh Kumar ◽  
Deepika C. Khakha ◽  
Raman Deep
Keyword(s):  
Mental Illness ◽  
Aggressive Behavior ◽  
Training Program ◽  
Mentally Ill ◽  
Warning Signs ◽  
Caregiver Training ◽  
Bonferroni Adjustment ◽  
Home Based ◽  
Post Test ◽  
At Home

In India, more than 90% of the patient with chronic mental illness stayed with their family members. Approximately 77.4% of caregivers experience moderate to severe levels of aggression. The purpose of this study was to evaluate the effectiveness of caregiver-training program on knowledge in managing aggressive behavior of mentally ill at home. Research design was pre-experimental. Seventy two caregivers were recruited using purposive sampling technique. The caregivers knowledge was assessed at 3 time points with regard to training program; before, immediately (post-test 1), and after 1 month (±1 week; post-test 2). The baseline knowledge was reflective of the deficiencies existing in the management of aggression of the mentally ill by caregivers. The knowledge of caregivers regarding the management of aggressive behavior of mentally ill, increased after caregiver training program, from the pre-test score of 17.63 ± 3.3 to post-test 1 score of 23.26 ± 2.9, and slightly decreased post-test 2 score of 21.01 ± 3.3 at p < .05. Repeated measure analysis of variance (ANOVA) was done to compare the differences in knowledge score over time with Bonferroni adjustment. This home based caregiver training program helped caregivers to identify etiological factors of aggression, warning signs of aggression and use of de-escalation strategies to manage aggressive behavior of mentally ill. Training caregivers regarding aggression management will make caregiver proficient in practicing safe approach during handling of aggressive patient which will ensure the physical safety of the caregiver as well as of the patient and let the patient stay at home.

Oral Antibiotic Management of Acute Osteomyelitis of the Hand: Outcomes and Cost Comparison to Standard Intravenous Regimen

Hand ◽  
2019 ◽  
pp. 155894471987314
Author(s):  
Mark Henry ◽  
Forrest H. Lundy
Keyword(s):  
Bone Loss ◽  
Direct Cost ◽  
Cost Model ◽  
Cost Savings ◽  
Cost Of Care ◽  
Cost Comparison ◽  
Study Cohort ◽  
Oral Antibiotic ◽  
Direct Inoculation ◽  
The Cost

Background: Acute, direct inoculation osteomyelitis of the hand has traditionally been managed by intravenous antibiotics. With proven high levels of bone and joint penetration, specific oral antimicrobials may deliver clinical efficacy but at substantially lower cost. Methods: Sixty-nine adult patients with surgically proven acute, direct inoculation osteomyelitis of the hand were evaluated for clinical response on a 6-week postdebridement regimen of susceptibility-matched oral antibiotics. Inclusion required gross purulence and bone loss demonstrated at the initial debridement and radiographic evidence of bone loss. Excluded were 2 patients with extreme medical comorbidities. There were 53 men and 16 women with a mean age of 46 years. Mean follow-up was 16 weeks (±10). The cost model for the outpatient oral antibiotic treatment was intentionally maximized using Walgreen’s undiscounted cash price. The cost model for the traditional intravenous treatment regimen was intentionally minimized using the fully discounted Medicare fee schedule. Results: All patients achieved resolution of osteomyelitis by clinical and radiographic criteria. In addition, 7 patients underwent successful subsequent osteosynthesis procedures at the previously affected site without reactivation. The mean postdebridement direct cost of care per patient in the study cohort was $482.85, the cost of the antibiotic alone. The postdebridement direct cost of care per patient on a regimen of vancomycin 1.5 g every 12 hours via peripherally inserted central catheter line was $21 646.90. Conclusions: Acute, direct inoculation osteomyelitis of the hand can be successfully managed on oral antibiotic agents with substantial direct and indirect cost savings.

Home-Based Versus Hospital-Based Care for People with Serious Mental Illness

1994 ◽  
Vol 165 (2) ◽  
pp. 179-194 ◽  
Author(s):  
I. M. Marks ◽  
J. Connolly ◽  
M. Muijen ◽  
B. Audini ◽  
G. McNamee ◽  
...  
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Social Adjustment ◽  
Daily Living ◽  
Emergency Admission ◽  
Controlled Study ◽  
Patient Admissions ◽  
Home Based ◽  
Home Based Care

Background.A controlled study tested whether the superior outcome of community care for serious mental illness (SMI) in Madison and in Sydney would also be found in inner London.Method.Patients from an inner London catchment area who faced emergency admission for SMI (many were violent or suicidal) were randomised to 20 months or more of either home-based care (Daily Living Programme, DLP; n = 92), or standard in-patient and later out-patient care (controls, n = 97). Most DLP patients had brief in-patient stays at some time. Measures included number and duration of in-patient admissions, independent ratings of clinical and social function, and patients' and relatives' satisfaction.Results.Outcome was superior with home-based care. Until month 20, DLP care improved symptoms and social adjustment slightly more, and enhanced patients' and relatives' satisfaction. From 3 to 18 months DLP care greatly reduced the number of in-patient bed days as long as the DLP team was responsible for any in-patient phase its patients had. Cost was less. DLP care did not reduce the number of admissions, nor of deaths from self-harm (3 DLP, 2 control). One DLP patient killed a child. Even at 20 months many DLP and control patients still had severe symptoms, poor social adjustment, no job, and need for assertive follow-up and heavy staff input. (Beyond 20 months most gains were lost apart from satisfaction.)Conclusions.It is unclear how much the gain until 20 months from home-based care was due to its site of care, its being problem-centred, its teaching of daily living skills, its assertive follow-up, the home care team's keeping responsibility for any in-patient phase, its coordination of total care (case management), or to other care components. Home-based care is hard to organise and vulnerable to many factors, and needs careful training and clinical audit if gains are to be sustained.

Direct cost comparison of group B streptococcus prophylaxis regimens in patients with penicillin allergy

2006 ◽  
Vol 195 (6) ◽  
pp. S52
Author(s):  
Clayton Fitzpatrick ◽  
Leo Brancazio ◽  
Terrence Allen ◽  
Geeta Swamy ◽  
Phillip Heine
Keyword(s):  
Direct Cost ◽  
Group B Streptococcus ◽  
Penicillin Allergy ◽  
Cost Comparison ◽  
Group B

scholarly journals Home based and hospital care for severe mental illness.

BMJ ◽  
1992 ◽  
Vol 304 (6837) ◽  
pp. 1313-1314
Author(s):  
T. J. Crow
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Hospital Care ◽  
Home Based

scholarly journals Family care of people with severe mental disorders: an integrative review

2015 ◽  
Vol 23 (2) ◽  
pp. 352-360 ◽  
Author(s):  
Maria Juan-Porcar ◽  
Lledó Guillamón-Gimeno ◽  
Azucena Pedraz-Marcos ◽  
Ana María Palmar-Santos
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Family Caregivers ◽  
Scientific Literature ◽  
Family Care ◽  
Integrative Review ◽  
Home Based ◽  
The Us ◽  
The Uk ◽  
Evidence Based Guidelines

OBJECTIVE: to analyze the scientific literature on home-based family care of people with severe mental illness. METHOD: integrative review of 14 databases (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, EMI, ISOC, JBI COnNECT, LILACS, PsycINFO, PubMed, SciELO, and Scopus) searched with the key words "family caregivers", "severe mental illness", and "home" between 2003 and 2013. RESULTS: of 787 articles retrieved, only 85 met the inclusion criteria. The articles appeared in 61 journals from different areas and disciplines, mainly from nursing (36%). The countries producing the most scientific literature on nursing were Brazil, the UK, and the US, and authorship predominantly belonged to university centers. A total of 54.12% of the studies presented quantitative designs, with descriptive ones standing out. Work overload, subjective perspectives, and resources were the main topics of these papers. CONCLUSIONS: the international scientific literature on home-based, informal family care of people with severe mental disorder is limited. Nursing research stands out in this field. The prevalent topics coincide with the evolution of the mental health system. The expansion of the scientific approach to family care is promoted to create evidence-based guidelines for family caregivers and for the clinical practice of professional caregivers.

Cost Comparison of Psychogeriatric Consultations: Outpatient Versus Home-Based Consultations

1994 ◽  
Vol 6 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Ajit Shah
Keyword(s):  
Home Visits ◽  
Cost Comparison ◽  
Comparison Study ◽  
Advantages And Disadvantages ◽  
Home Based ◽  
The Many ◽  
The Cost ◽  
Methodological Difficulties ◽  
At Home

In this article a cost-comparison study of psychogeriatric outpatient and home consultations (if all outpatients are seen at home) is reported. The cost of home visits was estimated to be less than that for outpatient consultations. The results are discussed in the context of methodological difficulties and the advantages and disadvantages of home and outpatient consultations. In view of the many advantages of home-based consultations, including lower costs, it is concluded that we should be developing and evaluating services with greater emphasis on home-based consultations.

Direct cost comparison of totally endoscopic versus open ear surgery

2017 ◽  
Vol 132 (2) ◽  
pp. 122-128 ◽  
Author(s):  
N Patel ◽  
A Mohammadi ◽  
N Jufas
Keyword(s):  
Direct Cost ◽  
Private Hospital ◽  
Hospital Setting ◽  
Cost Effective ◽  
Cost Comparison ◽  
Endoscopic Ear Surgery ◽  
Canal Wall ◽  
Ear Surgery ◽  
Hospital Perspective ◽  
Canal Wall Up

AbstractObjective:Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting.Methods:A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques.Results:Totally endoscopic ear surgery has a mean direct cost reduction of AUD$2978.89 per operation from the hospital perspective, when compared to canal wall up mastoidectomy.Conclusion:Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.

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