Economic Aspects of Daily Psychiatric Care II. Comparison of Patients in
Daily Care and Classical Hospitalization
Kitzlerová E.1, Howardová A.1, Půbal K.2, Kališová L.1, Sekot M.1, Baková N.1, Číhal L.3, Raboch J.1
Psychiatrická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. J. Raboch, DrSc.1 Vysoká škola ekonomická, Praha2 Ministerstvo zemědělství ČR, Praha3 |
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Summary:
Studies involving economic part of treatment are in our country more of an exeption. Studies published
in recent years show that treatment in a day hospital setting generally costs 1/3 less than comparable
inpatient treatment. Day hospital treatment can prevent or reduce the number of somatic
therapy measures. Patients treated in day care setting in the long run use less of follow up and outpatient
care is cheaper than inpatient treatment for both patients and relatives. The noted affirmations
are valid for about 20–40 % of persons with acute mental disorder.
The aim of the study was to identify and to compare the costs effectiveness in a day hospital setting
and inpatient treatment.
Recruitment of the patients was carried out according to defined inclusion and exlusion criterias.
Patients were randomised into group of day care setting and inpatient setting. Total number of patients
was 206 (106 in inpatient care, 100 in day care setting), they were assessed in several periods:
T1 – admission, T2 – 1 week after admission, T3 – 1 month after admission, T4 – during discharge, T5
– 3 months after discharge, T6 – 12 months after discharge. For the assessment of health care costs
was used the CSRI questionnaire and the data were processed by our own designed procedure –
“accountant way”. Psychopathology was assessed by BPRS questionnaire and treatment satisfaction
was assessed by the CAT questionnaire.
Results: The average length of stay was 39 days in both settings. 72% of patients in the group of day
care have finished the treatment, inpatient treatment (hospitalization) have finished 75.5% of them. Psychiatric treatment in the form of day care is 22% (342 EUR/10 944 CZK) cheaper than inpatient
care in some part of psychiatric patients with acute mental disorder (20–40%); this difference is statistically
significant. Outpatient psychiatrists, psychologists, general practitioners and other physicians
(neurologist, stomatologist, gynaecologist, surgeons etc.) were the most frequently used health
services in both settings since the discharge. Psychopathology improved similary in both followed
groups as well as the treatment satisfaction.
Key words:
acute mental disorder, day care, hospitalization, economic aspects.
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