(Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol
Abstract Background As severe mental illness (SMI) is associated with a high disease burden and persistent nature, patients with SMI are often subjected to long-term mental healthcare and are in need of additional social support services. Community-based care and support services are organized via d...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-022-04346-8 |
| _version_ | 1828329932524093440 |
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| author | Anne Kleijburg Ben Wijnen Silvia M. A. A. Evers Hans Kroon Joran Lokkerbol |
| author_facet | Anne Kleijburg Ben Wijnen Silvia M. A. A. Evers Hans Kroon Joran Lokkerbol |
| author_sort | Anne Kleijburg |
| collection | DOAJ |
| description | Abstract Background As severe mental illness (SMI) is associated with a high disease burden and persistent nature, patients with SMI are often subjected to long-term mental healthcare and are in need of additional social support services. Community-based care and support services are organized via different providers and institutions, which are often lacking structural communication, resulting in a fragmented approach. To improve the efficiency of care provision and optimize patient wellbeing, an integrated multi-agency approach to community-based mental health and social services has been developed and implemented. Aim To present a research protocol describing the evaluation of flexible assertive community teams integrated with social services in terms of effectiveness, cost-effectiveness, and implementation. Methods/design A quasi-experimental study will be conducted using prospective and retrospective observational data in patients with severe mental illness. Patients receiving care from three teams, consisting of flexible assertive community treatment and separately provided social support services (care as usual), will be compared to patients receiving care from two teams integrating these mental and social services into a single team. The study will consist of three parts: 1) an effectiveness evaluation, 2) a health-economic evaluation, and 3) a process implementation evaluation. To assess (cost-)effectiveness, both real-world aggregated and individual patient data will be collected using informed consent, and analysed using a longitudinal mixed model. The economic evaluation will consist of a cost-utility analysis and a cost-effectiveness analysis. For the process and implementation evaluation a mixed method design will be used to describe if the integrated teams have been implemented as planned, if its predefined goals are achieved, and what the experiences are of its team members. Discussion The integration of health and social services is expected to allow for a more holistic and recovery oriented treatment approach, whilst improving the allocation of scarce resources. This study aims to identify and describe these effects using a mixed-method approach, and support decision-making in the structural implementation of integrating mental and social services. |
| first_indexed | 2024-04-13T20:32:39Z |
| format | Article |
| id | doaj.art-ab61f946f8a444ce876a3a97b446264e |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-13T20:32:39Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-ab61f946f8a444ce876a3a97b446264e2022-12-22T02:31:08ZengBMCBMC Psychiatry1471-244X2022-11-0122111110.1186/s12888-022-04346-8(Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocolAnne Kleijburg0Ben Wijnen1Silvia M. A. A. Evers2Hans Kroon3Joran Lokkerbol4Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht UniversityCentre of Economic Evaluations & Machine Learning, Trimbos Institute, Netherlands Institute of Mental Health and AddictionDepartment of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht UniversityDepartment of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg UniversityCentre of Economic Evaluations & Machine Learning, Trimbos Institute, Netherlands Institute of Mental Health and AddictionAbstract Background As severe mental illness (SMI) is associated with a high disease burden and persistent nature, patients with SMI are often subjected to long-term mental healthcare and are in need of additional social support services. Community-based care and support services are organized via different providers and institutions, which are often lacking structural communication, resulting in a fragmented approach. To improve the efficiency of care provision and optimize patient wellbeing, an integrated multi-agency approach to community-based mental health and social services has been developed and implemented. Aim To present a research protocol describing the evaluation of flexible assertive community teams integrated with social services in terms of effectiveness, cost-effectiveness, and implementation. Methods/design A quasi-experimental study will be conducted using prospective and retrospective observational data in patients with severe mental illness. Patients receiving care from three teams, consisting of flexible assertive community treatment and separately provided social support services (care as usual), will be compared to patients receiving care from two teams integrating these mental and social services into a single team. The study will consist of three parts: 1) an effectiveness evaluation, 2) a health-economic evaluation, and 3) a process implementation evaluation. To assess (cost-)effectiveness, both real-world aggregated and individual patient data will be collected using informed consent, and analysed using a longitudinal mixed model. The economic evaluation will consist of a cost-utility analysis and a cost-effectiveness analysis. For the process and implementation evaluation a mixed method design will be used to describe if the integrated teams have been implemented as planned, if its predefined goals are achieved, and what the experiences are of its team members. Discussion The integration of health and social services is expected to allow for a more holistic and recovery oriented treatment approach, whilst improving the allocation of scarce resources. This study aims to identify and describe these effects using a mixed-method approach, and support decision-making in the structural implementation of integrating mental and social services.https://doi.org/10.1186/s12888-022-04346-8Integrated careSevere mental illnessFlexible assertive community treatmentMental healthcareSocial servicesCost-effectiveness |
| spellingShingle | Anne Kleijburg Ben Wijnen Silvia M. A. A. Evers Hans Kroon Joran Lokkerbol (Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol BMC Psychiatry Integrated care Severe mental illness Flexible assertive community treatment Mental healthcare Social services Cost-effectiveness |
| title | (Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol |
| title_full | (Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol |
| title_fullStr | (Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol |
| title_full_unstemmed | (Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol |
| title_short | (Cost)-effectiveness and implementation of integrated community-based care for patients with severe mental illness: a study protocol |
| title_sort | cost effectiveness and implementation of integrated community based care for patients with severe mental illness a study protocol |
| topic | Integrated care Severe mental illness Flexible assertive community treatment Mental healthcare Social services Cost-effectiveness |
| url | https://doi.org/10.1186/s12888-022-04346-8 |
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