Skip to main content Accessibility help
×
×
Home

Alternatives to standard acute in-patient care in England: readmissions, service use and cost after discharge

  • Sarah Byford (a1), Jessica Sharac (a1), Brynmor Lloyd-Evans (a2), Helen Gilburt (a1), David P. J. Osborn (a2), Morven Leese (a1), Sonia Johnson (a2) and Mike Slade (a1)...

Abstract

Background

Residential alternatives to standard psychiatric admissions are associated with shorter lengths of stay, but little is known about the impact on readmissions.

Aims

To explore readmissions, use of community mental health services and costs after discharge from alternative and standard services.

Method

Data on use of hospital and community mental health services were collected from clinical records for participants in six alternative and six standard services for 12 months from the date of index admission.

Results

After discharge, the mean number and length of readmissions, use of community mental health services and costs did not differ significantly between standard and alternative services. Cost of index admission and total 12-month cost per participant were significantly higher for standard services.

Conclusions

Shorter lengths of stay in residential alternatives are not associated with greater frequency or length of readmissions or greater use of community mental health services after discharge.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Alternatives to standard acute in-patient care in England: readmissions, service use and cost after discharge
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Alternatives to standard acute in-patient care in England: readmissions, service use and cost after discharge
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Alternatives to standard acute in-patient care in England: readmissions, service use and cost after discharge
      Available formats
      ×

Copyright

Corresponding author

Dr Sarah Byford, Centre for the Economics of Mental Health, Box PO24, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: s.byford@iop.kcl.ac.uk.

Footnotes

Hide All

Declaration of interest

None.

Footnotes

References

Hide All
1 Slade, M, Byford, S, Barrett, B, Lloyd-Evans, B, Gilburt, H, Osborn, DPJ, et al. Alternatives to standard acute in-patient care in England: short-term clinical outcomes and cost-effectiveness. Br J Psychiatry 2010 (suppl 53): s149.
2 Johnson, S, Lloyd-Evans, B, Morant, N, Gilburt, H, Shepherd, G, Slade, M, et al. Alternatives to standard acute in-patient care in England: roles and populations served. Br J Psychiatry 2010 (suppl 53): s613.
3 Curtis, L. The Unit Costs of Health and Social Care 2007. Personal Social Services Research Unit, 2007.
4 Department of Health. NHS Reference Costs 2007. Department of Health, 2007.
5 Wing, JK, Beevor, AS, Curtis, RH, Park, SB, Hadden, S, Burns, A. Health of the Nation Outcome Scales (HoNOS). Research and development. Br J Psychiatry 1998; 172: 11–8.
6 Jones, SH, Thornicroft, G, Coffey, M, Dunn, G. A brief mental health outcome scale – reliability and validity of the Global Assessment of Functioning (GAF). Br J Psychiatry 1995; 166: 654–9.
7 Salvi, G, Leese, M, Slade, M. Routine use of mental health outcome assessments: choosing the measure. Br J Psychiatry 2005; 186: 146–52.
8 Efron, B, Tibshirani, RJ. An Introduction to the Bootstrap. Chapman & Hall, 1993.
9 Thompson, SG, Barber, JA. How should cost data in pragmatic randomised trials be analysed? BMJ 2000; 320: 1197–200.
10 Byford, S, Barber, JA, Harrington, R. Factors that influence the cost of deliberate self-poisoning in children and adolescents. J Ment Health Policy Econ 2001; 4: 113–21.
11 Lloyd-Evans, B, Johnson, S, Morant, N, Gilburt, H, Osborn, DPJ, Jagielska, D, et al. Alternatives to standard acute in-patient care in England: differences in content of care and staff–patient contact. Br J Psychiatry 2010 (suppl 53): s4651.
12 Howard, L, Flach, C, Leese, M, Byford, S, Killaspy, H, Cole, L, et al. Effectiveness and cost-effectiveness of admissions to women's crisis houses compared with traditional psychiatric wards: pilot patient-preference randomised controlled trial. Br J Psychiatry 2010 (suppl 53): s3240.
13 Byford, S, Fiander, M, Torgerson, DJ, Barber, JA, Thompson, SG, Burns, T, et al. Cost-effectiveness of intensive v. standard case management for severe psychotic illness: UK700 case management trial. Br J Psychiatry 2009; 176: 537–43.
14 McCrone, P, Johnson, S, Nolan, F, Pilling, S, Sandor, A, Hoult, J, et al. Economic evaluation of a crisis resolution service: a randomised controlled trial. Epidemiol Psichiatr Soc 2009; 18: 54–8.
15 Johnson, S, Gilburt, H, Lloyd-Evans, B, Osborn, DPJ, Boardman, J, Leese, M, et al. In-patient and residential alternatives to standard acute psychiatric wards in England. Br J Psychiatry 2009; 194: 456–63.
16 Gilburt, H, Slade, M, Rose, D, Lloyd-Evans, B, Johnson, S, Osborn, DPJ. Service users' experience of residential alternatives to standard acute wards: qualitative study of similarities and differences. Br J Psychiatry 2010 (suppl 53): s2631.
17 Osborn, DPJ, Lloyd-Evans, B, Johnson, S, Gilburt, H, Byford, S, Leese, M, et al. Residential alternatives to acute in-patient care in England: satisfaction, ward atmosphere and service user experiences. Br J Psychiatry 2010 (suppl 53): s416.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Alternatives to standard acute in-patient care in England: readmissions, service use and cost after discharge

  • Sarah Byford (a1), Jessica Sharac (a1), Brynmor Lloyd-Evans (a2), Helen Gilburt (a1), David P. J. Osborn (a2), Morven Leese (a1), Sonia Johnson (a2) and Mike Slade (a1)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *