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Cost-effectiveness study of a home-based mental health hospitalization program for children and adolescents: study protocol

Published online by Cambridge University Press:  26 August 2025

I. Garcia Del Castillo
Affiliation:
Psychiatry, La Paz University Hospital, Madrid
L. Heredia Castro
Affiliation:
Psychiatry, La Paz University Hospital, Madrid
L. Caraballo Romero
Affiliation:
Psychiatry, La Paz University Hospital, Madrid
A. Ortiz Villalobos
Affiliation:
Psychiatry, La Paz University Hospital, Madrid
N. Fernandez Gomez
Affiliation:
Psychiatry, La Paz University Hospital, Madrid
C. Cañadas
Affiliation:
Psychiatry, Principe de Asturias University Hospital, Alcala de Henares
N. García
Affiliation:
Psychiatry, Principe de Asturias University Hospital
J. Andreo-Jover
Affiliation:
Psychiatry, Universidad Autonoma de Madrid Psychiatry, Hospital La Paz Institute for Health Research, Madrid, Spain
T. Alonso
Affiliation:
Psychiatry, Universidad Autonoma de Madrid Psychiatry, Hospital La Paz Institute for Health Research, Madrid, Spain
A. Gaona
Affiliation:
Psychiatry, Universidad Autonoma de Madrid Psychiatry, Hospital La Paz Institute for Health Research, Madrid, Spain
A. Moreno Perez
Affiliation:
Psychiatry, Principe de Asturias University Hospital, Alcala de Henares
M. F. Bravo Ortiz*
Affiliation:
Psychiatry, La Paz University Hospital, Madrid Psychiatry, Universidad Autonoma de Madrid Psychiatry, Hospital La Paz Institute for Health Research, Madrid, Spain
*
*Corresponding author.

Abstract

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Introduction

Psychiatric hospitalization to manage acute symptoms of mental disorders in children and adolescents may be necessary, although there is a growing concern about the clinical and economic effectiveness of psychiatric admission in this population. This suggests the need for the implementation of new intensive family and community care models that would reduce hospitalization.

Home hospitalization provides an opportunity to offer the child or adolescent with intensive treatment within the infrastructure of their home and the supervision of their family or primary caregivers. It therefore requires fewer resources than traditional inpatient treatment while allowing the patient‘s immediate environment to be involved in the treatment, potentially reducing the risk of a failed transition to the home once the patient is discharged.

Objectives

The main objective is to analyze the cost-effectiveness of two Mental Health Home Hospitalization interventions for adolescents as an alternative to traditional hospitalization in two hospitals in Madrid, Spain (La Paz University Hospital and Principe de Asturias University Hospital).

Methods

This is a quasi-experimental pre-post intervention study that examines two models of Mental Health Home Hospitalization as an alternative to full hospitalization. It will analyze various outcome variables, including clinical, functioning, satisfaction, quality of life, and costs /use of clinical resources.

Results

Participants must be adolescents and young adults aged 12 to 18 years (inclusive), who present a psychiatric decompensation requiring an intensity of care similar to that provided in the hospital. Assessments, including CGI, HoNOSCA, C-SSRS, CSQ-8, EQ-5D-Y, will be conducted at the baseline visit, and at the end of the treatment. Resource use and costs will be recorded at the baseline and six months after the treatment.

Conclusions

Home-based mental health hospitalization for adolescents is an emerging area of interest in the treatment of acute symptoms of mental disorders in this population, but there are not standard protocols for such interventions. Several issues remain to be clarified, including the care pathways for adolescents in crisis who require hospital care and whether organizational differences between interventions impact the outcomes.

Disclosure of Interest

None Declared

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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