Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitation
IntroductionThere has been a resurgence of interest in psychiatric rehabilitation to cater to patients with chronic and complex mental illnesses.AimsThis study is aimed at examining patients' characteristics and the prevalence of psychiatric and non-psychiatric comorbidity in a local inpatient...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-04-01
|
| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1140265/full |
| _version_ | 1797837993776513024 |
|---|---|
| author | Mahmoud A. Awara Mahmoud A. Awara Mahmoud A. Awara Mahmoud A. Awara Laura M. Downing Laura M. Downing Laura M. Downing Dorothy Edem Norma Lewis Joshua T. Green Joshua T. Green Joshua T. Green |
| author_facet | Mahmoud A. Awara Mahmoud A. Awara Mahmoud A. Awara Mahmoud A. Awara Laura M. Downing Laura M. Downing Laura M. Downing Dorothy Edem Norma Lewis Joshua T. Green Joshua T. Green Joshua T. Green |
| author_sort | Mahmoud A. Awara |
| collection | DOAJ |
| description | IntroductionThere has been a resurgence of interest in psychiatric rehabilitation to cater to patients with chronic and complex mental illnesses.AimsThis study is aimed at examining patients' characteristics and the prevalence of psychiatric and non-psychiatric comorbidity in a local inpatient rehabilitation service, as well as to investigate the impact of the whole-system approach to rehabilitation on future utilization of mental health services and to analyze the cost-effectiveness and quality of this service.MethodPatients managed over 3 years in a psychiatric rehabilitation inpatient unit were self-controlled; they were retrospectively (pre-rehabilitation) and prospectively (post-rehabilitation) examined for readmission rate, length of stay (LOS), and emergency room (ER) visits. Relevant information was retrieved from Discharge Abstract Database (DAD), Patient Registration System (STAR), and Emergency Department Information System (EDIS). The quality of care in the rehabilitation unit was examined using the Quality Indicator for Rehabilitative Care (QuIRC), and the cost analysis was conducted using data obtained from a single-payer government medical service insurance (MSI) billing system.ResultsOf the 185 patients admitted over the study period, 158 were discharged. There was a significant reduction in readmission rate (64% decrease), LOS (6,585 fewer days spent in hospital), and ER presentations (166 fewer visits) (P < 0.0001), respectively. There were substantial subsequent cost savings in the post-rehabilitation year.Conclusion and implications for practiceIn the 3-year study, an inpatient psychiatric rehabilitation service in Nova Scotia, Canada, resulted in the successful discharge of most patients with severe and persistent mental illness to more socially inclusive environments. It also reduced their post-rehabilitation mental health service utilization, hence greatly enhancing the effectiveness and efficiency of these services. |
| first_indexed | 2024-04-09T15:33:35Z |
| format | Article |
| id | doaj.art-af11b7ca9b9248789a437aaaa300f56e |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-09T15:33:35Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-af11b7ca9b9248789a437aaaa300f56e2023-04-28T04:40:39ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-04-011410.3389/fpsyt.2023.11402651140265Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitationMahmoud A. Awara0Mahmoud A. Awara1Mahmoud A. Awara2Mahmoud A. Awara3Laura M. Downing4Laura M. Downing5Laura M. Downing6Dorothy Edem7Norma Lewis8Joshua T. Green9Joshua T. Green10Joshua T. Green11Department of Psychiatry, Dalhousie University, Medical School, Halifax, NS, CanadaThe College of Physicians and Surgeons of Nova Scotia, Halifax, NS, CanadaThe Royal College of Psychiatrists, London, United KingdomMental Health and Addictions Services, Nova Scotia Health Authority, Halifax, NS, CanadaDepartment of Psychiatry, Dalhousie University, Medical School, Halifax, NS, CanadaThe College of Physicians and Surgeons of Nova Scotia, Halifax, NS, CanadaMental Health and Addictions Services, Nova Scotia Health Authority, Halifax, NS, CanadaMental Health and Addictions Services, Nova Scotia Health Authority, Halifax, NS, CanadaMental Health and Addictions Services, Nova Scotia Health Authority, Halifax, NS, CanadaDepartment of Psychiatry, Dalhousie University, Medical School, Halifax, NS, CanadaThe College of Physicians and Surgeons of Nova Scotia, Halifax, NS, CanadaMental Health and Addictions Services, Nova Scotia Health Authority, Halifax, NS, CanadaIntroductionThere has been a resurgence of interest in psychiatric rehabilitation to cater to patients with chronic and complex mental illnesses.AimsThis study is aimed at examining patients' characteristics and the prevalence of psychiatric and non-psychiatric comorbidity in a local inpatient rehabilitation service, as well as to investigate the impact of the whole-system approach to rehabilitation on future utilization of mental health services and to analyze the cost-effectiveness and quality of this service.MethodPatients managed over 3 years in a psychiatric rehabilitation inpatient unit were self-controlled; they were retrospectively (pre-rehabilitation) and prospectively (post-rehabilitation) examined for readmission rate, length of stay (LOS), and emergency room (ER) visits. Relevant information was retrieved from Discharge Abstract Database (DAD), Patient Registration System (STAR), and Emergency Department Information System (EDIS). The quality of care in the rehabilitation unit was examined using the Quality Indicator for Rehabilitative Care (QuIRC), and the cost analysis was conducted using data obtained from a single-payer government medical service insurance (MSI) billing system.ResultsOf the 185 patients admitted over the study period, 158 were discharged. There was a significant reduction in readmission rate (64% decrease), LOS (6,585 fewer days spent in hospital), and ER presentations (166 fewer visits) (P < 0.0001), respectively. There were substantial subsequent cost savings in the post-rehabilitation year.Conclusion and implications for practiceIn the 3-year study, an inpatient psychiatric rehabilitation service in Nova Scotia, Canada, resulted in the successful discharge of most patients with severe and persistent mental illness to more socially inclusive environments. It also reduced their post-rehabilitation mental health service utilization, hence greatly enhancing the effectiveness and efficiency of these services.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1140265/fullinpatient psychiatric rehabilitationclinical effectivenessquality of inpatient psychiatry carecost effectivenessthe effectiveness of inpatient psychiatry rehabilitation for severe and persistent mental illness |
| spellingShingle | Mahmoud A. Awara Mahmoud A. Awara Mahmoud A. Awara Mahmoud A. Awara Laura M. Downing Laura M. Downing Laura M. Downing Dorothy Edem Norma Lewis Joshua T. Green Joshua T. Green Joshua T. Green Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitation Frontiers in Psychiatry inpatient psychiatric rehabilitation clinical effectiveness quality of inpatient psychiatry care cost effectiveness the effectiveness of inpatient psychiatry rehabilitation for severe and persistent mental illness |
| title | Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitation |
| title_full | Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitation |
| title_fullStr | Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitation |
| title_full_unstemmed | Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitation |
| title_short | Three-year-cohort-study: clinical and cost effectiveness of an inpatient psychiatric rehabilitation |
| title_sort | three year cohort study clinical and cost effectiveness of an inpatient psychiatric rehabilitation |
| topic | inpatient psychiatric rehabilitation clinical effectiveness quality of inpatient psychiatry care cost effectiveness the effectiveness of inpatient psychiatry rehabilitation for severe and persistent mental illness |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1140265/full |
| work_keys_str_mv | AT mahmoudaawara threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT mahmoudaawara threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT mahmoudaawara threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT mahmoudaawara threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT lauramdowning threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT lauramdowning threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT lauramdowning threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT dorothyedem threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT normalewis threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT joshuatgreen threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT joshuatgreen threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation AT joshuatgreen threeyearcohortstudyclinicalandcosteffectivenessofaninpatientpsychiatricrehabilitation |