Deinstitutionalisation for Long-Term Mental Illness: Cost Differences in Hospital and Community Care

2000 ◽  
Vol 34 (3) ◽  
pp. 491-495 ◽  
Author(s):  
Helen M. Lapsley ◽  
Kate Tribe ◽  
Chris Tennant ◽  
Alan Rosen ◽  
Coletta Hobbs ◽  
...  
Keyword(s):  
Mental Illness ◽  
Psychiatric Hospital ◽  
Community Care ◽  
Hospital Costs ◽  
Hospital Setting ◽  
Community Setting ◽  
Income Data ◽  
The Cost ◽  
Cost Differences

Objective: This project studied the cost analysis of psychiatric hospital and then community care for long-stay patients with chronic mental illness discharged during the closure of a psychiatric hospital in Sydney. Method: Expenditure and income data in both settings were collected. Costs were analysed on an occupied bed-day basis. Results: The hospital setting cost more per patient per day compared with the various community costs which were one-third to one-half of the comparable hospital costs. Conclusions: The analysis demonstrated overall that hospital care was nearly twice as expensive as care in the community setting. The factors which may have influenced, although not necessarily altered, the substance of the findings largely related to ‘organisational efficiency’. The mental hospital as an older, more rigid system was likely to be less efficient than the newer community service provision which was under intensive scrutiny both clinically and financially by all interested parties.

scholarly journals Why Do Some Firms Spend So Much on Medical Care? Accounting for Variation

2000 ◽  
Vol 3 (1) ◽  
Author(s):  
Matthew Eichner ◽  
Mark McClellan ◽  
David A. Wise
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Health Care Expenditures ◽  
Cost Of Treatment ◽  
Consistent Method ◽  
The Difference ◽  
The Cost ◽  
Cost Differences ◽  
Average Expenditure

We are engaged in a long-term project to analyze the determinants of health care cost differences across firms. An important first step is to summarize the nature of expenditure differences across plans. The goal of this article is to develop methods for identifying and quantifying those factors that account for the wide differences in health care expenditures observed across plans.We consider eight plans that vary in average expenditure for individuals filing claims, from a low of $1,645 to a high of $2,484. We present a statistically consistent method for decomposing the cost differences across plans into component parts based on demographic characteristics of plan participants, the mix of diagnoses for which participants are treated, and the cost of treatment for particular diagnoses. The goal is to quantify the contribution of each of these components to the difference between average cost and the cost in a given firm. The demographic mix of plan enrollees accounts for wide differnces in cost ($649). Perhaps the most noticeable feature of the results is that, after adjusting for demographic mix, the difference in expenditures accounted for by the treatment costs given diagnosis ($807) is almost as wide as the unadjusted range in expenditures ($838). Differences in cost due to the different illnesses that are treated, after adjusting for demographic mix, also accounts for large differences in cost ($626). These components of cost do not move together; for example, demographic mix may decrease expenditure under a particular plan while the diagnosis mix may increase costs.Our hope is that understanding the reasons for cost differences across plans will direct more focused attention to controlling costs. Indeed, this work is intended as an important first step toward that goal.

scholarly journals Severe persistent mental illness

1992 ◽  
Vol 16 (12) ◽  
pp. 743-745 ◽  
Author(s):  
Peter F. Liddle
Keyword(s):  
Mental Illness ◽  
Mental Hospital ◽  
Community Care ◽  
Community Setting ◽  
Detailed Examination ◽  
Mental Illnesses ◽  
Persistent Mental Illness ◽  
Realistic Appraisal

Many patients with persistent mental illnesses enjoy a better life in a community setting than would be possible in a long stay mental hospital. Furthermore, the available evidence indicates that most such patients get better while living in the community. Unfortunately, community care has not served all patients well. Much of the difficulty can be attributed to lack of resources. However, there is also a tendency by planners to underestimate the severity of patients' disabilities. A realistic appraisal demands a detailed examination of the problems of patients whose needs have not been met by community care. One important issue is that of patients who fall through the net of community care and another is that of patients who have not but nonetheless have not survived in the community. This paper addresses the question of the needs of this latter group.

Factors impact the cost differences between INA-CBGs tariffs and hospital costs in JKN patients with appendicitis cases

2020 ◽  
Vol 30 ◽  
pp. 213-216
Author(s):  
Rofida Lathifah ◽  
Djazuly Chalidyanto ◽  
Widodo J. Pudjirahardjo
Keyword(s):  
Hospital Costs ◽  
The Cost ◽  
Cost Differences

Swedish mental health nurses' responsibility in supervised community care of persons with long-term mental illness

2004 ◽  
Vol 6 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Annabella Magnusson ◽  
Torbjorn Hogberg ◽  
Kim Lutzen ◽  
Elisabeth Severinsson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Community Care ◽  
Mental Health Nurses

scholarly journals After the madhouses: the emotional politics of psychiatry and community care in the UK tabloid press 1980–1995

2021 ◽  
pp. medhum-2020-012117
Author(s):  
Leah Sidi
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Community Care ◽  
Term Care ◽  
Hospital Patients ◽  
Emotional Politics ◽  
The Uk ◽  
Gendered Stereotypes ◽  
Tabloid Press

The deinstitutionalisation of mental hospital patients made its way into UK statutory law in 1990 in the form of the NHS and the Community Care Act. The Act ushered in the final stage of asylum closures moving the responsibility for the long-term care of mentally ill individuals out of the NHS and into the hands of local authorities. This article examines the reaction to the passing of the Act in two major tabloid presses, The Sun and The Daily Mirror, in order to reveal how community care changed the emotional terrain of tabloid storytelling on mental health. Reviewing an archive of 15 years of tabloid reporting on mental illness, I argue that the generation of ‘objects of feeling’ in the tabloid media is dependent on the availability of recognisable and stable symbols. Tabloid reporting of mental illness before 1990 reveals the dominance of the image of the asylum in popular understandings of mental illness. Here the asylum is used to generate objects of hatred and disgust for the reader, even as it performs a straightforward othering and distancing function. In these articles, the image of the asylum and its implicit separation of different types of madness into categories also do normative gender work as mental illness is represented along predictable gendered stereotypes. By performing the abolition of asylums, the 1990 Act appears to have triggered a dislodging of these narrative norms in the tabloid press. After 1990, ‘asylum stories’ are replaced with ‘community care stories’ which contain more contradictory and confusing clusters of feeling. These stories rest less heavily on gendered binaries while also demonstrating a near-frantic desire on the part of the mass media for a return of institutional containment. Here, clusters of feeling becoming briefly ‘unstuck’ from their previous organisations, creating a moment of affective flux.

Leaving hospital II: the cost-effectiveness of community care for former long-stay psychiatric hospital patients

1996 ◽  
Vol 5 (4) ◽  
pp. 379-394 ◽  
Author(s):  
JENNIFER BEECHAM ◽  
MARTIN KNAPP ◽  
SINEAD MCGILLOWAY ◽  
SHANE KAVANAGH ◽  
ANDREW FENYO ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Psychiatric Hospital ◽  
Community Care ◽  
Hospital Patients ◽  
The Cost

scholarly journals Kris Kristofferson/John Holt—‘Help Me Make It Through The Night’

2019 ◽  
Vol 43 (2) ◽  
pp. 92-95
Author(s):  
Simon Procter
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Music Therapy ◽  
Paranoid Schizophrenia ◽  
Community Setting ◽  
Service Users ◽  
Primary Reason ◽  
Health Community ◽  
Being There

As with all the contributors here, my chosen song comes from fieldwork. I spent time in an urban UK mental health community setting, a place which nobody has to attend (it is not part of the statutory psychiatric system), but where people choose to spend time to gain various kinds of support – formal and informal – whilst in other respects living independently despite (in most cases) having a psychiatric diagnosis. Most service users with whom I spent time were male, over forty, long-term unemployed, living on the economic edge, ever fearful about having their benefits withdrawn, and diagnosed with some form of mental illness, most commonly paranoid schizophrenia. My primary reason for being there was to participate in and observe the various interactions around the provision of music in general and music therapy in particular.  

A Scale of Disability and Prognosis in Long-Term Mental Illness

1974 ◽  
Vol 125 (588) ◽  
pp. 475-478 ◽  
Author(s):  
R. Morgan ◽  
J. Cheadle
Keyword(s):  
Mental Illness ◽  
Extensive Literature ◽  
Prognostic Test ◽  
Prognostic Criteria ◽  
Prognostic Tests ◽  
The Cost

Hoenig (1967) has recently and comprehensively summarized the extensive literature on the prognosis of schizophrenia. In a section on existing prognostic tests he criticizes the vagueness of the items to be scored, the variety of prognostic criteria and the low validity of the resulting scales. The present paper describes an attempt to devise a new prognostic test, using material which was originally collected in order to study the cost of rehabilitation.

Radiofrequency ablation versus cryoablation for atrioventricular nodal re-entrant tachycardia in children: a value comparison

2016 ◽  
Vol 27 (2) ◽  
pp. 224-228
Author(s):  
Matthew E. Oster ◽  
Zhou Yang ◽  
Kay Stewart-Huey ◽  
Michelle Glanville ◽  
Arlene Porter ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Hospital Costs ◽  
Fixed Costs ◽  
Short Term ◽  
A Value ◽  
Labour Costs ◽  
Acute Success ◽  
The Cost ◽  
Procedure Type

AbstractBackgroundIt is unclear whether cryoablation or radiofrequency ablation offers better value for treating atrioventricular nodal re-entrant tachycardia in children. We aimed to compare the value of these procedures for treating atrioventricular nodal re-entrant tachycardia in children, with value being outcomes relative to costs.MethodsWe performed a retrospective cohort study of all atrioventricular nodal re-entrant tachycardia ablations for children (age⩽18 years) from July, 2009 to June, 2011 at our institution. Costs included fixed costs, miscellaneous hospital costs, and labour costs, and key outcomes were acute and long-term success (6 months) of the ablations. We conducted T-tests and regression analyses to investigate the associations between the ablation procedure type and the cost and success of the ablations.ResultsOf 96 unique cases performed by three paediatric electrophysiologists, 48 were cryoablation only, 42 radiofrequency ablation only, and six were a combination. Acute success was 100% for the cryoablation only and radiofrequency ablation only cases and 83% for the combination cases. There were no notable adverse events. The average total cost was $9636 for cryoablation cases, $9708 for radiofrequency ablation cases, and $10,967 for combination cases (p=0.51 for cryoablation only versus radiofrequency ablation only). The long-term success rate was 79.1% for cryoablation only, 92.8% for radiofrequency ablation only, and 66.7% for the combination (p=0.01 for cryoablation only versus radiofrequency ablation only), but long-term success varied notably by provider.ConclusionsCryoablation and radiofrequency ablation offer similar value in the short term for the treatment of atrioventricular nodal re-entrant tachycardia in children. Differences in long-term success may vary substantially by physician, and thus may lead to differences in long-term value.

Sign in / Sign up

Export Citation Format

Share Document