PMID: 9545999Apr 18, 1998Paper

Cost comparison of state hospital and community-based care for seriously mentally ill adults

The American Journal of Psychiatry
A B RothbardE Kuno

Abstract

In 1989, Philadelphia began a bold experiment involving the total shutdown of a 500-bed state hospital. This study examines the service utilization and cost of treating individuals with serious mental illness in a community-based care system in which the state hospital was replaced with 60 extended acute care beds in general hospitals and 583 residential beds. A pre-post study design was used to determine the utilization and cost differences before and after the state hospital closed for individuals with a diagnosis of schizophrenia who required extended psychiatric hospitalization following an acute care crisis episode in a general hospital. The number and cost of days spent in general and in extended hospital and residential treatment were compared on an episode and an annual basis. The results of this analysis showed that after the state hospital closed, the direct treatment cost of an episode of care increased from $68,446 to $78,929, and the average annual cost of care per patient increased from $48,631 to $66,794 because of an increase in acute care hospitalization. This study suggests that an "admission" cohort of seriously mentally ill patients requires an optimal mix of acute care, extended care, and residential beds, ...Continue Reading

Citations

Oct 1, 2005·Mental Health Services Research·Eri KunoJoel Greenwald
Oct 9, 2001·New Directions for Mental Health Services·L L Bachrach
May 2, 2001·The Journal of Behavioral Health Services & Research·R RosenheckS Essock
Jul 30, 1999·The Journal of Behavioral Health Services & Research·J H McGrewB A Pescosolido
Jul 30, 1999·The Journal of Behavioral Health Services & Research·J H McGrewE C McDonel
Jul 30, 1999·The Journal of Behavioral Health Services & Research·E R Wright
Sep 24, 2008·Archives of Psychiatric Nursing·Ching-Lan Esther LinPing-Chuan Hsiung
Nov 30, 2000·Epidemiologia e psichiatria sociale·A D Lesage
Sep 25, 1999·New Directions for Mental Health Services·H P Lefley
Dec 28, 1999·New Directions for Mental Health Services·L L Bachrach
Dec 28, 1999·New Directions for Mental Health Services·M B Monroe-DeVita, D F Mohatt
Oct 26, 1999·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·G E Davis, W E Lowell

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