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11 records – page 1 of 2.

Alternatives to acute hospital psychiatric care in east-end Montreal.

https://arctichealth.org/en/permalink/ahliterature191229
Source
Can J Psychiatry. 2002 Feb;47(1):49-55
Publication Type
Article
Date
Feb-2002
Author
Alain D Lesage
Charles Bonsack
Doris Clerc
Claude Vanier
Maryse Charron
Marc Sasseville
André Luyet
Daniel Gélinas
Author Affiliation
Centre de recherche Fernand-Seguin, Hôpital Louis-H Lafontaine, Unité 218, 7401 Hochelaga, Montréal, PQ H1N 3M5. alesage@ssss.gouv.gc.ca
Source
Can J Psychiatry. 2002 Feb;47(1):49-55
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Aged
Catchment Area (Health)
Community Mental Health Services - economics - organization & administration - utilization
Female
Hospitalization - economics
Hospitals, Psychiatric - economics - utilization
Humans
Male
Mental Disorders - economics - epidemiology - rehabilitation
Middle Aged
Needs Assessment
Patient Admission - statistics & numerical data
Quebec - epidemiology
Abstract
As pressure mounts to reduce the number of costly acute care beds, governments and the literature propose top-down ratios. Is this reasonable and fair to the responsible medical officers who, as the key care providers, will need to admit patients and develop discharge plans in a reduced-beds environment?
Treating physicians of all acute care inpatients on a given day (n = 212) and all new acute care admissions over a 2-week period (n = 125) completed an adapted version of the Nottingham Acute Beds Use Survey (NABUS) Questionnaire.
On a given day, only 62 of 212 inpatients were unsuited for any alternative to acute care hospitalization. A floor ratio of 18 acute care beds per 100,000 inhabitants seems adequate for the catchment area in question, provided that alternatives to hospitalization are fully and efficiently available. Alternatives essentially involve an array of the following: supervised residential settings, day hospitals, and intensive home care (2 to 6 hours weekly). The ratio of intensive home care workers required would be 25 per 100,000 inhabitants.
PubMed ID
11873708 View in PubMed
Less detail

[Communal housing for the mentally ill. A supplement or an alternative to the existing psychiatric institutions]

https://arctichealth.org/en/permalink/ahliterature73655
Source
Ugeskr Laeger. 1991 Feb 4;153(6):432-5
Publication Type
Article
Date
Feb-4-1991
Author
K W Maarbjerg
A. Vogel
Author Affiliation
Københavns Kommunehospital, psykiatrisk afdeling.
Source
Ugeskr Laeger. 1991 Feb 4;153(6):432-5
Date
Feb-4-1991
Language
Danish
Publication Type
Article
Keywords
Adult
Community Mental Health Services - economics - organization & administration
Community-Institutional Relations - economics
Denmark
English Abstract
Female
Hospitalization
Housing
Humans
Length of Stay
Male
Mental Disorders - rehabilitation
Abstract
In 1980-1981, two communal housing schemes for young psychiatric patients in the Municipality of Copenhagen were established. The object was to offer these persons a home for a limited period (maximum three years). The object of this investigation is to describe the patients who lived in these communal homes during the period 1.3.1980-28.2.1989, to investigate the duration of hospitalization in psychiatric departments two years before and two years after they stay in the communal home and, on the basis of the experience gained, to discuss the possibilities and limitations of this form of housing. The investigation is retrospective and based on hospital case records. It includes 56 persons: 37 men and 19 women. The average age was 28.7 years. 92% of the residents had a chronic psychiatric disease. They had received psychiatric treatment early and had long histories with prolonged periods of hospitalization. The average duration of hospitalization was 17 months. At the conclusion of the investigation, 33 residents had moved out two or more years ago. The average duration of hospitalization for this group was reduced to approximately 1/3 of the duration of hospitalization prior to the stay in the communal home. The structure outlined here may be employed for a number of the chronic psychiatric patients but a communal psychiatric offer should include a greater spectrum of possibilities for chronic patients to cover their requirements. Establishing an offer of this type demands multidisciplinary cooperation.
PubMed ID
2000649 View in PubMed
Less detail

Cost-effectiveness of early intervention in first-episode psychosis: economic evaluation of a randomised controlled trial (the OPUS study).

https://arctichealth.org/en/permalink/ahliterature118731
Source
Br J Psychiatry. 2013 Jan;202(1):35-41
Publication Type
Article
Date
Jan-2013
Author
Lene Halling Hastrup
Christian Kronborg
Mette Bertelsen
Pia Jeppesen
Per Jorgensen
Lone Petersen
Anne Thorup
Erik Simonsen
Merete Nordentoft
Author Affiliation
Region Zealand, Psychiatric Research Unit, Roskilde, Denmark. lhhs@regionsjaelland.dk
Source
Br J Psychiatry. 2013 Jan;202(1):35-41
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Community Mental Health Services - economics - organization & administration
Cost-Benefit Analysis
Denmark
Diagnosis-Related Groups - economics
Early Medical Intervention - economics
Family Therapy - economics
Health Care Costs - statistics & numerical data
Health Services - utilization
Humans
Intention to Treat Analysis
Middle Aged
Outcome and Process Assessment (Health Care)
Patient Care Team - economics
Patient Education as Topic - economics
Psychotic Disorders - economics - therapy
Schizophrenia - economics - therapy
Single-Blind Method
Socialization
Young Adult
Abstract
Information about the cost-effectiveness of early intervention programmes for first-episode psychosis is limited.
To evaluate the cost-effectiveness of an intensive early-intervention programme (called OPUS) (trial registration NCT00157313) consisting of enriched assertive community treatment, psychoeducational family treatment and social skills training for individuals with first-episode psychosis compared with standard treatment.
An incremental cost-effectiveness analysis of a randomised controlled trial, adopting a public sector perspective was undertaken.
The mean total costs of OPUS over 5 years (€123,683, s.e. = 8970) were not significantly different from that of standard treatment (€148,751, s.e. = 13073). At 2-year follow-up the mean Global Assessment of Functioning (GAF) score in the OPUS group (55.16, s.d. = 15.15) was significantly higher than in standard treatment group (51.13, s.d. = 15.92). However, the mean GAF did not differ significantly between the groups at 5-year follow-up (55.35 (s.d. = 18.28) and 54.16 (s.d. = 18.41), respectively). Cost-effectiveness planes based on non-parametric bootstrapping showed that OPUS was less costly and more effective in 70% of the replications. For a willingness-to-pay up to €50,000 the probability that OPUS was cost-effective was more than 80%.
The incremental cost-effectiveness analysis showed that there was a high probability of OPUS being cost-effective compared with standard treatment.
PubMed ID
23174515 View in PubMed
Less detail

A demonstration program for chronic recidivists of criminal justice, health, and social service agencies.

https://arctichealth.org/en/permalink/ahliterature231757
Source
Int J Law Psychiatry. 1989;12(2-3):211-29
Publication Type
Article
Date
1989

[Drug addicts with severe mental disorders can be helped by programs using moderate means. Good results when psychiatric, social and drug abuse services cooperate]

https://arctichealth.org/en/permalink/ahliterature10438
Source
Lakartidningen. 2000 May 3;97(18):2205-6
Publication Type
Article
Date
May-3-2000
Author
T. Palmstierna
K. Gadd
C. Norman
J. Svensson
Author Affiliation
S:t Görans sjukhus, Beroendecentrum Nord, Stockholm. tom.palmstierna@mailbox.euromail.se
Source
Lakartidningen. 2000 May 3;97(18):2205-6
Date
May-3-2000
Language
Swedish
Publication Type
Article
Keywords
Community Mental Health Services - economics - organization & administration
Cost-Benefit Analysis
English Abstract
Follow-Up Studies
Homeless Persons - psychology
Humans
Mentally Disabled Persons - psychology - rehabilitation
Prognosis
Psychotic Disorders - complications - psychology - rehabilitation
Regional Medical Programs - economics
Social Support
Social Work, Psychiatric - economics - organization & administration
Substance-Related Disorders - complications - psychology - rehabilitation
Sweden
Abstract
Dependency disorders are more common than expected in psychiatric populations. Untreated, dual diagnosis leads to severe social and psychiatric deterioration. Nine treatment resistant, homeless, drug addicts suffering from chronic psychotic disorders were selected to take part in a case management program, integrating social services with regular psychiatric treatment. All but one were greatly improved in general terms as well as regarding their ability to maintain an ordered life style. The need for institutional care decreased dramatically.
PubMed ID
10850050 View in PubMed
Less detail

Evaluation of a telepsychiatry pilot project.

https://arctichealth.org/en/permalink/ahliterature200719
Source
J Telemed Telecare. 1999;5(1):38-46
Publication Type
Article
Date
1999
Author
S. Doze
J. Simpson
D. Hailey
P. Jacobs
Author Affiliation
Crossroads Regional Health Authority, Wetaskiwin, Canada.
Source
J Telemed Telecare. 1999;5(1):38-46
Date
1999
Language
English
Publication Type
Article
Keywords
Canada
Community Mental Health Services - economics - organization & administration
Costs and Cost Analysis
Evaluation Studies as Topic
Hospitals, General
Hospitals, Psychiatric
Humans
Pilot Projects
Psychiatry - economics - methods
Telemedicine - economics - methods
Abstract
We assessed a telepsychiatry pilot project in which a psychiatric hospital was linked with mental health clinics in five general hospitals. Information was collected through questionnaires administered to patients, service providers and psychiatric consultants, and by interviews. The technology was considered easy to use by participating health-care professionals and patients, and the quality of the sound and picture was adequate. Survey data suggested acceptance and satisfaction on the part of patients, service providers and psychiatric consultants. An economic analysis indicated that at 396 consultations per year the service cost the same as providing a travelling psychiatrist (C$610 per consultation); with more consultations, telepsychiatry was cheaper. Information gathered during the evaluation suggested that the use of videoconferencing for psychiatric consultations was a viable option for an integrated, community-based mental health service.
PubMed ID
10505368 View in PubMed
Less detail

Forty years of deinstitutionalization of psychiatric services in Canada: an empirical assessment.

https://arctichealth.org/en/permalink/ahliterature180086
Source
Can J Psychiatry. 2004 Apr;49(4):249-57
Publication Type
Article
Date
Apr-2004
Author
Patricia Sealy
Paul C Whitehead
Author Affiliation
Chelsey Park Long-Term Care, London, Ontario.
Source
Can J Psychiatry. 2004 Apr;49(4):249-57
Date
Apr-2004
Language
English
Publication Type
Article
Keywords
Canada
Community Mental Health Services - economics - organization & administration - utilization
Deinstitutionalization - economics - statistics & numerical data - trends
Empirical Research
Health Expenditures - statistics & numerical data - trends
Health Facility Closure
Health Plan Implementation
Hospitals, Psychiatric - utilization
Humans
Patient transfer
Psychiatric Department, Hospital - utilization
Abstract
To empirically analyze the implementation of the policy of deinstitutionalization of psychiatric services over a 40-year period.
We assessed the policy of deinstitutionalization in terms of the following components: 1) population-based psychiatric beds, days of care in psychiatric hospitals (PHs); 2) days of care in psychiatric units in general hospitals (GHs); and 3) per capita expenditures on psychiatric services.
There was a rapid closure of beds in PHs in the 1970s and 1980s, but this was associated with an increasing rate of days of care in psychiatric units in GHs (that is, transinstitutionalization). It was not until the 1990s that the overall days of inpatient care began to decrease. Per capita expenditures on community-based psychiatric services increased throughout this period.
Standardized rates reveal tremendous variation among the provinces in the timing and intensity of deinstitutionalization.
PubMed ID
15147023 View in PubMed
Less detail
Source
Sygeplejersken. 1992 Jun 3;92(23):9-10
Publication Type
Article
Date
Jun-3-1992

[The mentally ill in Stockholm suffer because of cost savings and re-organizations].

https://arctichealth.org/en/permalink/ahliterature184417
Source
Lakartidningen. 2003 Jun 19;100(25):2243-4
Publication Type
Article
Date
Jun-19-2003

[The psychiatric reform was necessary--but a lot of work is still to be done to achieve the goals].

https://arctichealth.org/en/permalink/ahliterature181249
Source
Lakartidningen. 2004 Feb 5;101(6):493-4
Publication Type
Article
Date
Feb-5-2004

11 records – page 1 of 2.