Impact of a specialized early intervention service for psychotic disorders on patient characteristics, service use, and hospital costs in a defined catchment area

Karen Goldberg, Ross Norman, Jeffrey S Hoch, Norbert Schmitz, Deborah Windell, Nicole Brown, Ashok Malla

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Objective: To evaluate the impact of a new early intervention service for first-episode psychosis on patient characteristics, service use, and hospital costs. Method: We examined clinical records of all first admissions to hospitals of patients diagnosed with first-episode psychoses (nonaffective) over a 3-year period before and after the introduction of an early intervention service, the Prevention and Early Intervention Program for Psychosis (PEPP), in a defined catchment area. We examined demographic, clinical, and service use indices covering a 2-year period subsequent to the index admission for each patient. Results: Patients in the post-PEPP phase were significantly younger (P < 0.01), were more often male (P < 0.05), and were less likely to be admitted to hospital with an involuntary status (P < 0.05) or with injuries (P < 0.05) at the time of their first hospital admission. Over the 2 years following the initial admission, post-PEPP patients had significantly fewer admissions to a regular psychiatric service (P < 0.001) and made significantly fewer visits to the hospital emergency department (P < 0.01). There was a significant mean reduction in costs per case of regular hospital bed use ($1028.49, SD 528.02, compared with $792. 28, SD 528.02; P < 0.01) and emergency visits ($519.18, SD 353.79, compared with $353.79, SD 345.0; P < 0.01). Time series analyses followed by Chow tests failed to confirm that these cost changes could be attributed specifically to the introduction of an early intervention service. Conclusion: Introduction of a specialized early intervention program may be beneficial to patients and to the health care system. To evaluate the cost-benefit ratio of early intervention services, longer term and more detailed data may be required.

Original languageEnglish (US)
Pages (from-to)895-903
Number of pages9
JournalCanadian Journal of Psychiatry
Volume51
Issue number14
StatePublished - Dec 2006
Externally publishedYes

Keywords

  • Costs
  • Early intervention
  • First episode psychoses
  • Service use

ASJC Scopus subject areas

  • Psychiatry and Mental health

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