Citation

Thornton PH, Goldman HH, Stegner BL, Rappaport M, Sorensen JE, Attkisson CC. Eval. Program Plann. 1990; 13(3): 231-241.

Copyright

(Copyright © 1990, Elsevier Publishing)

DOI

10.1016/0149-7189(90)90054-Z

PMID

unavailable

Abstract

This paper describes the research findings and methodology used to evaluate the relative cost effectiveness of two systems of acute psychiatric care: system I when only a general hospital unit was available and system 2 when a psychiatric health facility was added to the general hospital service system. The cost analysis methodology is described in detail. Theta, cost-outcome matrices, and data analytic techniques useful in making cost effectiveness judgments and program policy decisions are demonstrated. Problems associated with conducting this type of research in a service delivery system are described and discussed. Clinical outcome in system 1, when only the general hospital unit was available, was consistently better. Per diem costs for system 2, consisting of the general hospital unit and a nonhospital psychiatric health facility, were significantly less. However, the increased length of stay for system 2 patients made episode cost comparisons nearly equal between the two systems of health care. Results suggested the need for modifications in the new service system and the importance of assessing the cost and outcome of treatment simultaneously in making program policy decisions.