Cheung Desmond, Roper Leslie, Purdon Scot E
Edmonton Early Psychosis Intervention Clinic, Edmonton, Alberta, Canada; Division of Neuropsychology, Alberta Hospital Edmonton, Edmonton, Alberta, Canada.
Early Interv Psychiatry. 2014 Nov;8(4):375-81. doi: 10.1111/eip.12093. Epub 2013 Oct 7.
To estimate the public health costs of specific help-seeking pathways into an early intervention psychosis clinic.
The sequence of police, emergency and mental health contacts utilized by 50 patients up to 1 year prior to admission was characterized using chart reviews and structured interviews. Cost estimates for contacts were obtained from provincial health/public service cost reports.
A high-cost inpatient pathway and a low-cost outpatient pathway were identified, with the former exceeding the latter by a factor of 18.5 in cost. This discrepancy was attributable to both the high cost of inpatient services and the long duration of inpatient admissions, as well as more frequent inpatient use of high-cost urgent services (e.g. police, emergency services).
Given the substantial cost differential between inpatient and outpatient routes, additional clarification of modifiable factors that determine pathways to care could have significant implications to health service delivery costs for this population.
评估进入早期干预精神病诊所的特定求助途径所产生的公共卫生成本。
通过病历审查和结构化访谈，对50名患者入院前长达1年的警方、急诊和心理健康接触顺序进行了描述。接触成本估计数来自省级卫生/公共服务成本报告。
确定了一条高成本住院途径和一条低成本门诊途径，前者的成本比后者高出18.5倍。这种差异既归因于住院服务的高成本和住院时间的延长，也归因于住院患者更频繁地使用高成本紧急服务（如警方、急诊服务）。
鉴于住院和门诊途径之间存在巨大的成本差异，进一步明确决定护理途径的可改变因素可能会对该人群的卫生服务提供成本产生重大影响。
