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Community Psychiatric Nurse Teams: Cost-effectiveness of Intensive Support Versus Generic Care

Published online by Cambridge University Press:  02 January 2018

Paul McCrone ,
Jennifer Beecham  and
Martin Knapp
Paul McCrone
Affiliation:
Psychiatric Research in Service Measurement, Institute of Psychiatry, London
Jennifer Beecham
Affiliation:
Personal Social Services Research Unit, University of Kent and Centre for the Economics of Mental Health, Institute of Psychiatry, London
Martin Knapp*
Affiliation:
Personal Social Services Research Unit, University of Kent and Centre for the Economics of Mental Health, Institute of Psychiatry, London
*
Professor M. Knapp, Personal Social Services Research Unit, Cornwallis Building, University of Kent, Canterbury CT2 7NF
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Abstract

Background.

Part of the community psychiatric nurse (CPN) service was reorganised into a community support team (CST), with staff acting as case managers. An economic evaluation ran parallel to the comparison with generic CPN care.

Method.

Eighty-two clients were randomly allocated to experimental and control groups. Costs were comprehensively measured over a pre-referral period (three months), and then at 6, 12, and 18 months.

Results.

The economic evaluation found a cost difference between the groups. Generic group costs averaged £89 per patient per week more than CST group costs. The difference was only significant for the first six months. Changes in the burden of cost across agencies were observed.

Conclusions.

Although CPN inputs and costs were higher for the CST group, there was a significant short-term reduction in total cost. Beyond the short term, the CST did not confer cost or cost-effectiveness advantages.

Type
Papers
Information
The British Journal of Psychiatry , Volume 165 , Issue 2 , August 1994 , pp. 218 - 221
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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References

Beecham, J. K. & Knapp, M. R. J. (1992) Costing psychiatric options. In Measuring Mental Health Needs (eds Thornicroft, G., Brewin, C. & Wing, J. K.). London: Gaskell.Google Scholar
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Knapp, M. R. J. (1994) Community mental health services: towards an understanding of cost-effectiveness. In Evaluation of Community Psychiatric Services (eds Creed, F. & Tyrer, P.). Cambridge: Cambridge University Press (in press).Google Scholar
Knapp, M. R. J. & Beecham, J. K. (1990) Costing mental health services. Psychological Medicine, 20, 893–908.Google Scholar
Netten, A. (1994) Unit Costs of Community Care. Canterbury: Personal Social Services Research Unit, University of Kent.Google Scholar
Netten, A. & Beecham, J. K. (1993) (eds) Costing Community Care: Theory and Practice. Alder shot: Ashgate.Google Scholar
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