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Economic evaluation of a crisis resolution service: A randomised controlled trial

Published online by Cambridge University Press:  11 April 2011

Paul McCrone ,
Sonia Johnson ,
Fiona Nolan ,
Stephen Pilling ,
Andrew Sandor ,
John Hoult ,
Nigel McKenzie ,
Marie Thompson  and
Paul Bebbington
Paul McCrone*
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London (United Kingdom)
Sonia Johnson
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical Schools, University College London (United Kingdom)
Fiona Nolan
Affiliation:
Camden and Islington Mental Health and Social Care Trust, London (United Kingdom)
Stephen Pilling
Affiliation:
CORE (British Psychological Psychology), Sub-Department of Clinical Health Psychology, University College London (United Kingdom)
Andrew Sandor
Affiliation:
Central and North West London Mental Health NHS Trust, London (United Kingdom)
John Hoult
Affiliation:
Camden and Islington Mental Health and Social Care Trust, London (United Kingdom)
Nigel McKenzie
Affiliation:
Camden and Islington Mental Health and Social Care Trust, London (United Kingdom)
Marie Thompson
Affiliation:
Department of Clinical Psychology, University of Surrey, Guildford (United Kingdom)
Paul Bebbington
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical Schools, University College London (United Kingdom)
*
Address for correspondece: Dr. P. McCrone, P024 Health Service and Population Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF (United Kingdom). E-mail:p.mccrone@iop.kcl.ac.uk
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Summary

Aims – The use of specialised services to avoid admission to hospital for people experiencing mental health crises is seen as an integral part of psychiatric services in some countries. The aim of this paper is to assess the impact on costs and costeffectiveness of a crisis resolution team (CRT). Methods – Patients who were experiencing mental health crises sufficient for admission to be considered were randomised to either care provided by a CRT or standard services. The primary outcome measure was inpatient days over a six-month follow-up period. Service use was measured, costs calculated and cost-effectiveness assessed. Results – Patients receiving care from the CRT had non-inpatient costs £768 higher than patients receiving standard care (90% CI, £153 to £1375). With the inclusion of inpatient costs the costs for the CRT group were £2438 lower for the CRT group (90% CI, £937 to £3922). If one less day spent as an inpatient was valued at £100, there would be a 99.5% likelihood of the CRT being costeffective. Conclusion – This CRT was shown to be cost-effective for modest values placed on reductions in inpatient stays.

Keywords

costs and cost analysiscommunity mental health servicescrisis interventioneconomics
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 18 , Issue 1 , March 2009 , pp. 54 - 58
Copyright
Copyright © Cambridge University Press 2009

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