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08 Cost-effectiveness of home treatment for acute mental illness

 

For 30 years, the growing trend has been to treat patients with acute mental illness at home. This practice increases satisfaction among the persons concerned and reduces relapses. Nevertheless, there is little data available on the cost-effectiveness and on the factors governing the success of this approach.

Portrait / project description (ongoing research project)

The study combines three methodological approaches. First, the clinical effectiveness of home treatment will be evaluated by means of a quasi-experimental approach. Patients in the Bellinzona and tre Valli district will be assigned to the intervention group, while those in the Lugano district will form the control group (intervention on the ward). For each group, indicators such as the length of the intervention in days (treatment phase) and the symptoms and relapses during the following two years (follow-up phase) will be compared. Secondly, the complex interactions between the patients, specialist teams and relations/families will be subject to a qualitative analysis. Thirdly, the direct and indirect costs (sick days) of the intervention group and the control group will be examined.

Background

In 2016, the psychiatric hospital of the canton of Ticino closed a unit. Instead, a psychiatric home treatment service was instituted in the district of Bellinzona and Tre Valli. Studies show that integrating psychiatric care in the community can reduce hospital admissions. This practice also allows patients’ own resources to be put to better use and improves support for the patients’ families.

Aim

The study aims to analyse the feasibility, acceptance and cost-effectiveness of home treatment for acute mental illness. The objective is to mitigate the risk of relapse while reducing the costs of psychiatric treatment.

Relevance / Application

The study will improve understanding of the potential, in clinical and financial terms, of home treatment for acute mental illness. It will provide indications as to the conditions necessary for the treatment to be successful, particularly in terms of organisation, training of specialist teams, integration of home treatment within the healthcare system and in terms of patient profiles.

Original title

There's no place like home: Testing the cost-effectiveness of home treatment for acute mental illness in Ticino

Project Leaders

Applicant:

  • Prof. Dr. Luca Crivelli, Department of Business economics, health and social care, University of Applied Sciences and Arts of Southern Switzerland

Co-applicants:

  • Prof. Emiliano Albanese, Centre Collaborateur OMS, Département de psychiatrie, Hôpitaux Universitaires de Genève (HUG)
  • Prof. Wolfram Kawohl, Psychiatrie- und Psychotherapie, Psychiatrische Dienste Aargau AG, Brugg

Project partners:

  • Prof. Marco Borghi, Cattedra di economia pubblica, Facoltà di Scienze economiche USI e ETHZ
  • Dr. Rafael Traber, Dipartimento della sanità e della socialitâ, Organizzazione sociopsichiatrica cantonale, Ticino

 

 

Further information on this content

 Contact

Prof. Dr. Luca Crivelli Head of Department of Business economics, health and social care – University of Applied Sciences and Arts of Southern Switzerland Vice-Director Swiss School of Public Health+ Professor at Università della Svizzera italiana Stabile Piazzetta
Via Violino 11
6928 Manno +41 58 666 64 50 luca.crivelli@supsi.ch

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