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Changing Patterns of Mentall Health Care
Author(s) -
HÄFNER HEINZ
Publication year - 1985
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.1985.tb08531.x
Subject(s) - cohort , mental health , medicine , mental health care , health care , cohort study , inpatient care , day care , cohort effect , gerontology , psychiatry , nursing , pathology , economics , economic growth
The evaluation of intra‐ and extramural psychiatric care nowadays calls for new models and methods of services research as the transition from custodial to community mental health care results in patterns of utilization of high complexity. Not only the capacity and the components of the care system has changed considerable but also the composition of the cared patient groups. In Mannheim 3/4 of the schizophrenic patients requiring institutioned care for one year or more are admitted to sheltered homes and appartments due to the establishment of complementary sevices in the last 15 years. Data of a representation cohort of 148 schizophrenics observed over a period of 18 months show that corresponding to the multiple needs of the patients multiple needs of the patients multiple utilization prevails. The efectiveness of extramural care can be demonstrated by a reduced probability of readmission to inpatient treatment. The economic efficiency of the provision of complementary care was evaluated by analyzing coostts of service use by the cohort. The diect costs per case of all the servies utilized over on year averaged 43% compared with an uninterrupted stay in a mental state hospital. Also in community mental health care almost 80% of the total costs accrue rom hospital readmission due to relapses.