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Economic impact of crisis intervention in emergency psychiatry: a naturalistic study

Published online by Cambridge University Press:  16 April 2020

Cristian Damsa ,
Christopher Hummel ,
Vedat Sar ,
Thierry Di Clemente ,
Susanne Maris ,
Coralie Lazignac ,
Odile Massarczyk  and
Charles Pull
Cristian Damsa*
Affiliation:
Emergency and Crisis Intervention Unit, University of Geneva Psychiatric Center, Switzerland Psychiatric Department, Hospital Center of Luxembourg, 4 Barblé Street, 1210Luxembourg
Christopher Hummel
Affiliation:
Department of psychiatry; 1 Boston Medical Center Place, Dowling 7, Boston, MA02118, United States
Vedat Sar
Affiliation:
Department of psychiatry, University Istanbul Medical School, Istanbul, Turkey
Thierry Di Clemente
Affiliation:
Resident, Emergency Psychiatry, Hospital Center of Luxembourg
Susanne Maris
Affiliation:
Clinical psychologist, private practice, Geneva, Switzerland
Coralie Lazignac
Affiliation:
Emergency and Crisis Intervention Unit University of Geneva, Psychiatric Center, Switzerland
Odile Massarczyk
Affiliation:
Psychologist, psychoanalyst, Liège, Belgium
Charles Pull
Affiliation:
Professor of psychiatry, Hospital Center of Luxembourg Psychiatric Department, Hospital Center of Luxembourg, 4 Barblé Street, 1210Luxembourg
*
*Corresponding author: Service d’accueil, d’urgence et de liaison psychiatrique, hôpital cantonal universitaire de Genève, 24, rue Micheli-du-Crest, 1211 Genève, Switzerland. Tél.: +41 223 723 866, fax:+41 223 728 599. E-mail address:c.damsa@bluewin.ch. (C. Damsa).
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Abstract

Objective

This is a naturalistic study comparing the outcomes of all emergency psychiatric interventions in the Hospital Center of Luxemburg during two periods of six months each, before and after the introduction of a crisis intervention program. The aim of the study was to investigate the clinical and economic impact of crisis intervention on psychiatric emergency admissions.

Methods

All subjects admitted to the emergency psychiatric unit during the two study periods were considered for participation. Data were collected retrospectively and comparisons were made between patients before (September 1, 2001 to February 28, 2002) and after (September 1, 2002 to February 28, 2003) crisis intervention programs were established.

Results

A comparison between the two patient groups demonstrated a significant decrease in the rate of voluntary hospitalizations after crisis intervention, and a significant increase in the number of patients with subsequent outpatient consultations. The cost increase due to ambulatory follow-ups was widely compensated for by the cost decrease due to hospitalization avoidance.

Conclusion

These preliminary findings suggest that crisis intervention leads to a shift from hospitalization to outpatient psychotherapeutic management in emergency psychiatric services, which has a significant economic impact.

Keywords

Psychiatric emergencyCrisis interventionVoluntary hospitalizationAmbulatory follow-up
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 8 , December 2005 , pp. 562 - 566
Copyright
Copyright © Elsevier SAS 2005

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References

Andreoli, ALalive, JGarrone, GCrise et intervention de crise en psychiatrie. Paris: Simep; 1986.Google Scholar
Baillon, GAccueil, urgence, crise, que choisir?. Inf Psychiatrique. 1988;64:1087–1101.Google Scholar
Bengelsdorf, HChurch, JOKaye, RAOrlowski, BAlden, DCThe cost effectiveness of crisis intervention. Admission diversion saving can offset the high cost of service. J Nerv Ment Dis 1993;181:757–762.10.1097/00005053-199312000-00008CrossRefGoogle Scholar
Damsa, CDi Clemente, TMassarczyk, OVasilescu, M.-C.Haupert, JPredescu, Aet al.L’intervention de crise dans un service d’urgences psychiatriques diminue le nombre d’hospitalisations volontaires en psychiatrie. Ann Med Psychol (Paris). 2003;161:693–699.10.1016/j.amp.2003.09.002CrossRefGoogle Scholar
Damsa, CDi Clemente, TMassarczyk, OHaupert, JPull, CThe impact of crisis intervention on the management of patients with personality disorder. Bull Soc Sci Med Grand Duche Luxemb 2003;2:87–96.Google Scholar
Dazord, AGerin, PReith, BIahns, JFAndreoli, ACrisis intervention : assessment process and long-term follow-up of patients. Encephale. 1992;18:639–645.Google ScholarPubMed
De Clercq M. Urgences psychiatriques et interventions de crise. Paris, De Boeck & Larcier, Bruxelles, 1997.Google Scholar
Gabbard, GOLazar, SGHornberger, JSpiegel, DThe economic impact of psychotherapy: a review. Am J Psychiatry 1997;154:147–155.Google ScholarPubMed
Guthrie, EMoorey, JMargison, FBarker, HPalmer, SMcGrath, Get al.Cost-effectiveness of brief psychodynamic-interpersonal therapy in high utilizers of psychiatric services. Arch Gen Psychiatry 1999;56:519–526.10.1001/archpsyc.56.6.519CrossRefGoogle ScholarPubMed
Hillard, JRManual of Emergency Psychiatry Washington DC: American Psychiatric Press; 1990.Google Scholar
Hugo, MSmout, MBannister, JA Comparison in hospitalization rates between a community-based mobile emergency service and a hospital-based emergency service. Aust N Z J Psychiatry 2002;36: 504–508.10.1046/j.1440-1614.2002.01042.xCrossRefGoogle Scholar
Oldham, JMDeMasi, MEAn integrated approach to emergency psychiatric care. New Dir Ment Health Serv 1995;67: 33–42.10.1002/yd.23319650306CrossRefGoogle Scholar
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