Cost-Effectiveness Analysis of an Aftercare Service Vs Treatment-As-Usual for Patients With Severe Mental Disorders Pubmed



Barfar E¹ ; Sharifi V² ; Amini H² ; Mottaghipour Y³ ; Yunesian M⁴ ; Tehranidoost M² ; Sobhebidari P² ; Rashidian A¹ Show Affiliations
Source: Journal of Mental Health Policy and Economics Published:2017

Abstract

Background: There have been claims that community mental health principles leads to the maintenance of better health and functioning in patients and can be more economical for patients with severe and chronic mental disorders. Economic evaluation studies have been used to assess the cost-effectiveness of national health programs, or to propose efficient strategies for health care delivery. Aims of the Study: The current study is intended to test the costeffectiveness of an Aftercare Service when compared with Treatment-As-Usual for patients with severe mental disorders in Iran. Methods: This study was a parallel group randomized controlled trial. A total of 160 post-discharge eligible patients were randomized into two equal patient groups, Aftercare Service (that includes either Home Visiting Care, or Telephone Follow-up for outpatient treatment) vs Treatment-As-Usual, using stratified balanced block randomization method. All patients were followed for 12 months after discharge. The perspective of the present study was the societal perspective. The outcome measures were the rate of readmission at the hospitals after discharge, psychotic symptoms, manic symptoms, depressive symptoms, illness severity, global functioning, quality of life, and patients' satisfaction with the services. The costs included the intervention costs and the patient and family costs in the evaluation period. Results: There was no significant difference in effectiveness measures between the two groups. The Aftercare Service arm was about 66,000 US$ cheaper than Treatment-As-Usual arm. The average total cost per patient in the Treatment-As-Usual group was about 4651 US$, while it was reduced to 3823 US$ in the Aftercare Service group; equivalent to a cost reduction of about 800 US$ per patient per year. Copyright © 2017 ICMPE.