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The Evaluation of Mental Health Care Systems

Published online by Cambridge University Press:  02 January 2018

Heinz Häfner  and
Wolfram an der Heiden
Heinz Häfner*
Affiliation:
University of Heidelberg and Director of the Central Institute of Mental Health in Mannheim
Wolfram an der Heiden
Affiliation:
University of Heidelberg and Director of the Central Institute of Mental Health in Mannheim
*
∗ Correspondence
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Abstract

While the demand for deinstitutionalisation, strongly supported by the economic aspect of the issue, has resulted in a steep decline in the number of psychiatric beds in many Western countries, the evaluation of extramural psychiatric care has several difficulties, including that of proving effectiveness without experimental control of confounding influences. For a cohort of schizophrenic patients we investigated the impact of outpatient psychiatric treatment on length of stay in hospital and length of stay in the community. Outpatient care had a significant influence on read mission, but no effect on the length of inpatient treatment. While the average cost of community care was less than half that of traditional hospital care, in 6% of the patients this threshold value of continued inpatient care was exceeded. There also seems to be a non-monetary threshold, above which community care is no longer appropriate.

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Type
Papers
Information
The British Journal of Psychiatry , Volume 155 , Issue 1 , July 1989 , pp. 12 - 17
Copyright
Copyright © The Royal College of Psychiatrists 

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