Implementation and effectiveness of a bed reduction project.

A legislative mandate to shift a cohort of patients from the state hospital into intensive community treatment created an opportunity to explore questions about the impact of intensive community treatment on hospital utilization and quality of life. Information on prior and subsequent hospital utilization was taken from the state client information system. Information on community services and quality of life was obtained by interviewing clients in their homes, interviewing others who knew the clients, and by making direct observations of the clients' circumstances. Twenty-five of the intensively served clients were interviewed two to three months after discharge, as were 17 comparable clients who did not receive the intensive services. Clients did, in fact, receive more and better community services, their quality of life was better, and hospital utilization was dramatically reduced for both the targeted clients and the entire county catchment area.