Treatment strategies for reducing costs of acute psychiatric hospitalization.

Under new cost-containment regulations such as diagnostically related groups (DRGs) and capitation-based programs such as health maintenance organizations (HMOs), it will be advantageous to employ treatment strategies which reduce the utilization of hospitalization for acute psychiatric episodes. Results of clinical research studies have demonstrated that if a comprehensive system of mental-health care delivery is employed, alternatives to hospitalization can be less costly and often more effective clinically. Examples of alternative ambulatory treatment strategies include vigorous treatment of prodromal symptoms to prevent full relapse from occurring, family crisis therapy, home care, and day hospitalization. If hospitalization cannot be avoided, brief hospitalization is often at least as effective clinically as standard hospitalization and is certainly less expensive. As the impact of prospective payment plans increases, it is predicted that there will be a shift away from the central role of hospitalization in the treatment of acute psychiatric disorders.