Cost-Effectiveness Analysis of Continuity of Care System  in Severe Mental Illness High Risk to Violence Patients  at Primary Care Setting vs Routine Service System

Mongkol Siritheptawee; Pitchaya Wattanagaroon; Jamnian Suravarangkul; Khanista Chumsuk; Jutamanee Dudsedeeprasert; Pareyaasiri Witoonchart

doi:10.14456/rmj.2018.16

Authors

Mongkol Siritheptawee Nakhon Ratchasima Rajanagarindra Psychiatric Hospital, Nakhon Ratchasima,Thailand
Pitchaya Wattanagaroon Nakhon Ratchasima Rajanagarindra Psychiatric Hospital, Nakhon Ratchasima,Thailand
Jamnian Suravarangkul Excellence Center of Community Mental Health Care Service of Nakhon Ratchasima Rajanagarindra Psychiatric Hospital, Nakhon Ratchasima, Thailand
Khanista Chumsuk Excellence Center of Community Mental Health Care Service of Nakhon Ratchasima Rajanagarindra Psychiatric Hospital, Nakhon Ratchasima, Thailand
Jutamanee Dudsedeeprasert Excellence Center of Community Mental Health Care Service of Nakhon Ratchasima Rajanagarindra Psychiatric Hospital, Nakhon Ratchasima, Thailand
Pareyaasiri Witoonchart Department of Communication Sciences and Disorders / Center for Health Policy and Management, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.14456/rmj.2018.16

Keywords:

Continuity of care, Severe mental illness high risk to violence patient

Abstract

Background: The mental illness high risk to violence patients are a part of the mental illness patients that need to have continually well care. Since these patients have tendency of psychiatric relapse and mental health risks, the continuity of care system in mental illness patients project was created.

Objective: To compare the cost and effectiveness by using cost-effectiveness analysis between continuity of care system (home health care service every 1 month) in severe mental illness high risk to violence patients at primary care setting versus routine service system in provider perspective.

Methods: Data was derived from randomized controlled trial study between 1 January, 2016, to 30 June, 2016. The psychiatric patients which had diagnosed with F200 - 299 and 1 or more criteria of severe mental illness high risk to violence were recruited to the research.

Results: There were 105 patients for continuity of care system and 107 patients for routine service system. The frequency of psychiatric relapse and mental health risks (violence and re suicide) of patients for continuity of care system was lower than routine service system or 0.14 of patients with relapse and mental health risks in continuity of care system were lower than routine service system. The incremental cost-effectiveness ratio was -13,738.5 baht per patient. Number needed to treat (NNT) of relapse and mental health risks was 27.27 and rehospitalization was 90.9.

Conclusions: This study showed that the continuity of care system can reduce relapse, violence and mental health risks in severe mental illness psychiatric patients.

References

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